I utilize a company that assist clients in submitting a Superbill to their insurance company for reimbursement at no charge to the client., making it an easy process to access out-of-network services. You will pay for services at the time they are provided and then the Superbill is submitted on your behalf to your insurance company through the services I use and you will get reimbursed directly from your insurance provider. You can learn more about Superbilling at: www.thesuperbill.com
How does a Superbill payment work?
Superbills are provided to clients and insurance companies that are out of network. Superbill's request reimbursed from your insurance company for a part of your costs. You can contact your insurance provider to learn if you have out-of-network benefits. It is important to know what your benefits are before beginning treatment. If your insurance provider confirms that you have out-of-network benefits, you may be reimbursed for some of the costs you paid out of pocket. A Superbill shows an itemized list of services that you have received from an out-of-network provider. It’s like a detailed invoice or receipt.
How much can I expect to be reimbursed after I submit my Superbill?
Your insurance company will process your reimbursement according to the details of your plan. Based on your insurance carrier’s policies and your plan, several factors determine how much you may be reimbursed. These factors include:
- The amount allowed for a therapy service based on what your insurance company would pay for an in-network therapist
- Your out-of-network benefit level
- Whether you have met your out-of-network provider deductible for the year
- Your coinsurance rate for out-of-network providers (the percentage of charges your insurance company expects you to pay)
When you put all these factors together, here’s an example of what you might expect to be reimbursed by your insurance company:
You paid your therapist $180 for a 45-minute therapy session out of pocket and submitted a Superbill to your insurance carrier. Your plan determines that your coinsurance is 50% for this therapy session (or $90). You have met your deductible for the year and are therefore eligible to be reimbursed. When processed, your insurance carrier will reimburse you $90 for your therapy session.