What Is a Superbill? How to Use Out-of-Network Insurance Benefits at Love Meets Therapy
You Can Work With an Out-of-Network Therapist
Seeking the right therapist these days is a lot of work. First, you use your insurance directory to find a therapist who takes your insurance but they have no idea how to do EMDR or they’ve never even heard of ENM. Then you find a therapist who works exactly with the content and type of support you need but you worry about the cost of therapy and don’t know how to use out-of-network benefits. This is where understanding the process of using a superbill to seek reimbursement for therapy services comes in handy.
It’s a bird. It’s a plane. It’s a superbill!
In all seriousness, a superbill is actually pretty super. A superbill is a document that your therapist provides to you that has the information you need to submit a claim for reimbursement to your insurance company through your out-of-network benefits. It contains your mental health diagnosis, the exact service code for the type of therapy you received, any modifier numbers that show you received telehealth or in-person services, and information about the therapy practice, such as tax ID, address, and your therapist's name. All of this information can be sent by you directly to your insurance company or filled out in a form that your insurance company provides to you.
How to Check Your Out-of-Network Benefits
As a client using a superbill, your responsibilities include calling your insurance company to verify their reimbursement process with a superbill. Here are a list of questions to clarify with your insurance company before beginning therapy services:
“Does my plan cover out-of-network outpatient mental-health services?”
“What is my out-of-network deductible, and how much have I met?”
“What percentage will my plan reimburse after the deductible?”
“What is the allowed amount for CPT code 90837 ( individual therapy, 53 minutes) and 90847 (couples and family therapy)?”
“How do I submit a superbill?”
“Is preauthorization required?”
“What is the deadline for submitting a claim?”
Why Choose Private-Pay or Out-of-Network Therapy?
Choosing an out-of-network (or private-pay) therapist gives you more options for care that is specialized to your needs. At Love Meets Therapy, we are working towards panelling with more insurance companies each day. While we accept many plans, we may not yet be in-network with your specific insurance company. That doesn’t mean that you don’t still have access to affordable, specialized, and tailor-to-you therapy services. Love Meets Therapy offers specialized therapy services in EMDR and trauma therapy, somatic therapy, therapy for non-monogamy and relationships, sex therapy, neurodivergent care, and cultural-affirming therapy that might be difficult to find elsewhere. Using a superbill can make these services more accessible today.
How Superbills Work at Love Meets Therapy
All private-pay clients can request to receive a superbill from LMT. We cannot guarantee reimbursement, which is why communicating with your insurance company is the first step in this process. If your insurance company gives you the green light, then your therapist will set you up with an automated superbill form that is sent to your email on the first of every month. As a client, you will pay for the full cost of the therapy session at the time of services, then receive the superbill each month and send it to your insurance company. If your insurance company sends the superbill back or denies your claim, LMT will work with you to verify that all the information needed is included in the form and will provide a new copy for you to submit. Your insurance company makes the final decision with coverage, but we will be there with you for every step in the process!
Still have questions?
Reach out to your provider at LMT with any questions you have on using a superbill for therapy reimbursement in Washington state. Our providers at Love Meets Therapy are knowledgeable and caring and will help guide you through the process. Go ahead and schedule a free consultation to explore which therapist may be the right fit and learn whether a superbill is available for your services.
