Looking for a therapist can be a daunting task, and it's essential to understand the differences between in-network and out-of-network providers. While in-network therapists offer lower prices due to negotiated rates with your insurance company, out-of-network providers can be a valuable option for those seeking specialized care or experiencing long wait times with in-network therapists.

If you choose to see an out-of-network therapist, it's important to know that you will have to pay the full price of the session upfront. However, depending on your health insurance plan, you may receive partial reimbursement, making therapy more affordable.

To help you navigate your out-of-network benefits, we've put together a step-by-step guide:

1. Check your out-of-network benefits

   Look for information on your out-of-network deductible and coinsurance in your Summary of Benefits, included in a member information packet or on your insurance company website. Your out-of-network deductible is the amount you have to pay before being eligible for reimbursement. Once you've met your deductible, you'll receive partial reimbursement for therapy services. Coinsurance is the percentage of the service fee you're responsible for paying, with the insurance company reimbursing you for the remainder. Some insurance companies determine an "allowed amount," which caps the session fee they'll cover.

2. Call your insurance company to verify your benefits

   To ensure you have accurate information, call your insurance company member services line to ask about your out-of-network deductible and coinsurance for outpatient mental health, whether you need a referral from an in-network provider to see an out-of-network therapist, and how to submit claim forms for reimbursement.

Some questions to ask your insurance company that may be helpful:

• Do I have out-of-network benefits for mental health services?

• What is my out-of-network deductible and co-insurance?

• Do my out-of-network benefits cover virtual mental health services?

1. Ask your therapist for a Superbill

   Your therapist will provide you with a document called a Superbill that you can then send directly to your insurance company at the end of each month. The Superbill details how many sessions you've had and the total fee.

2. Receive out-of-network reimbursement

   Pay your therapist the entire session fee at the time of service, and depending on your specific plan, your insurance company will mail you a check to reimburse a portion of that cost.

Now partnered with Reimbursify!

To help you with reimbursement, Clover Counseling has partnered with Reimbursify, a secure, HIPAA-compliant payment option to provide you with a simple way to get reimbursed by your insurance for out-of-network services. Reimbursify charges a small rate per claim to use their services. These services allow you to submit your SuperBill (a form I provide every month that includes all of the information about your services and charges) through the Reimbursify app. Reimbursify then does all of the work to contact your insurance company to help get you reimbursed for the out-of-network services I provide.

For more information on Reimbursify click here.

To download the Reimbursify app on the app store click here. To download on Google Play click here.

If you are already a client and would like to submit a claim through Reimbursify, click here.

With these steps, you can make the most of your insurance and expand your search for the right therapist. Don't hesitate to take advantage of out-of-network providers if they meet your needs. Remember, taking care of your mental health is a crucial investment in yourself. Ready to take the leap? Schedule an appointment here!