Guide to Using Your Out-of-Network Benefits
If you would like to use out-of-network insurance benefits, Panoramic Counseling will provide you with a monthly superbill on the 5th of every month to submit to your insurance company for potential reimbursement. A superbill is an itemized receipt of your sessions that includes all necessary information for reimbursement, such as session dates, CPT codes, and fees paid. This guide will help you gather the information you need from your insurance provider.
Step One: Call Your Insurance
Use the customer service number on the back of your insurance card, typically listed under "Member Services" or "Behavioral Health."
Step Two: Ask a Few Key Questions
Write down the answers to ensure you understand your out-of-network benefits.
Out-of-Network Coverage: Does my plan cover out-of-network mental health providers?
Deductible: What is my out-of-network deductible? And how much of my deductible have I met this year?
Reimbursement: What percentage of the session fee will be reimbursed? Is there a maximum amount reimbursed per session?
How do I submit a claim? What is the process for submitting a claim? How long do I have to submit a claim after the date of service?
CPT Codes: You can confirm reimbursement rates for these common therapy session codes:
90791: Initial Evaluation
90834: Therapy Session (45 minutes)
90837: Therapy Session (60 minutes)
Step Three: Submit Your Claim
After services have been rendered you will:
Obtain the Superbill
We’ll provide you with a superbill on the 5th of each month. It includes all necessary details, such as session dates, CPT codes, and fees paid.
Submit the Superbill to Your Insurance
Follow your insurance company’s instructions for submitting claims. This can often be done online or through an app.
Follow Up
You may wish to check on the status of your claim after submission to ensure processing.