Insurance Reimbursement:
How to Receive 50-80% of Your Payment Refunded for Psychotherapy Services
We are happy to provide you with a monthly superbill (receipt) for “out-of-network” mental health therapy sessions. Kristin Stiles-Hall, LICSW is officially “credentialed” with many health insurance plans, but provides "out-of-network" (OON) care. Many clients wonder what “out-of-network” care means, and we hope this brief explanation helps. Please see disclaimer at the end of this blog. If you have further questions, please don’t hesitate to reach out.
In-Network vs. Out-of-Network Coverage
When you visit a healthcare provider on your insurance plan’s approved list, you’re seeing an “in-network” provider. These providers choose to apply and engage in a contracted agreement to work with your insurance plan. “Out-of-network” (OON) providers are those not on your plan’s list. Therefore, the “out-of-network” providers choose not to be “paneled” with your insurance company; the provider did not engage in a contracted agreement to work with an insurance plan. Some health insurance plans only cover in-network services; usually an HMO. While many cover both in-network and out-of-network care; usually PPOs.
Please check with your individual insurance plan to understand benefits.
We understand the frustration and discouragement of searching for an in-person/ tele-health provider only to find full practices or waitlists. When you’re ready to seek support, waiting isn’t always an option. That’s why we aim to make accessing care as seamless as possible.
Common Misconceptions About Out-of-Network Services
It’s a common misconception that out-of-network services are not covered by insurance. In reality, many health insurance plans reimburse 50-80% of the cost of out-of-network services, assuming you’ve met your deductible. Additionally, the superbill we provide often counts toward your deductible. If your insurance plan doesn’t offer a wide range of providers or services within its network, exploring out-of-network options can be a great solution. Working with an out-of-network provider like Kristin Stiles-Hall, LICSW means we can focus fully on your care without the administrative burdens of insurance, ensuring a deeper level of privacy and personalized attention.
What Is a Superbill?
A superbill is a specialized receipt created for insurance companies that details the services provided during your session. Unlike traditional receipts, superbills include important information like diagnosis and procedure codes that insurance companies use to reimburse you directly after payment. Superbills are an excellent way to recover costs for out-of-network services. Many people underestimate how much they can be reimbursed. Remember, most insurance plans reimburse between 50-80% of costs. By taking the time to understand your plan’s out-of-network coverage, you may discover that your investment in your well-being is far more affordable than you initially thought.
Why Choose Out-of-Network Care?
One of the key benefits of working with an out-of-network provider is the ability to prioritize your care over navigating insurance bureaucracy. This approach allows us to dedicate our energy fully to supporting you. Additionally, it ensures a higher level of privacy and a more personalized therapeutic experience. You are worth the investment in your mental health and well-being. We encourage you to explore your insurance options and take advantage of the potential cost savings. If you have questions or need guidance, please don’t hesitate to contact us—we’re here to help.
Disclaimer:
The information provided in this blog is for general informational purposes only and is based on publicly available resources and personal understanding of health insurance terminology. I am not a licensed insurance professional, and this content should not be considered professional advice. Readers are encouraged to consult directly with their insurance provider or a qualified professional for personalized guidance regarding their health insurance options. I disclaim any liability for actions taken based on the information presented here.
Kristin Stiles-Hall, LICSW, EMP
Clinical Social Worker, Psychotherapeutic Reiki & Energy Therapy
Services
Holistic Psychotherapeutic Reiki & Energy Therapy. Reiki can supports your body's natural ability to heal: works on a mental, spiritual, physical and emotional level; accretes the body natural healing process, detoxifies the body; effects each individual in very different ways based on where the body draws energy towards. Your self awareness can be the basis of your healing. In a balanced state, you will feel more steady in your life. You have an opportunity to meet stress with less anxiety & more calm strength.
Holistic Psychotherapeutic Reiki
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Reiki & full spectrum
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Reiki as a complimentary modality
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