Out-of-Network Benefits & Insurance Reimbursement

Clients are sometimes surprised to learn how much of the session fee their insurance provider may cover once their out-of-network (OON) benefits kick in.

When your plan includes OON benefits, reimbursement often ranges from 50-80%, making your cost per session approximately $35-$87.50 after a deductible is met.

While I do not have a direct relationship with insurance providers and require payment of my full fee at the time of service, I can file your insurance claims to facilitate the process for you. When eligible for reimbursement, most clients receive checks from their insurance company by mail within a few weeks.

Clients can also file their own claims, and I can provide a detailed superbill for each session.

If a claim is denied or delayed, clients are responsible for contacting their insurance provider to determine the cause and next steps. I am happy to update and resubmit claims if needed, but communication with your insurer must be managed directly by you.

Please note that courtesy billing is offered as a service to simplify the reimbursement process but does not guarantee payment. Reimbursement amounts and timelines vary based on your plan.

Questions to Ask Your Insurer

Before starting therapy, it helps to call your insurer and ask:

• Do I have out-of-network benefits for therapy sessions?

• What is my out-of-network deductible, and how much of it has been met?

• What percentage of the session cost will I be reimbursed for?

• Do I need prior authorization for out-of-network services?

• How do I submit or track a claim for reimbursement?

Why I Practice Exclusively Out-of-Network

Greater privacy
Insurance companies frequently request progress notes, treatment plans, or other clinical details when a therapist is in-network. Out-of-network, the only information ever shared (and only if you want insurance reimbursement) is the date of service, procedure code, fee, and diagnosis. Everything we discuss stays between us.

No external limits on care
In-network panels may cap the number of sessions, require pre-authorization, or push for short-term “evidenced based” approaches that are standardized and can be more easily replicated, over approaches that pursue deeper work. Staying outside of insurance contracts means we decide together how long and how often we meet, based on what actually helps rather than what a third party approves.

Consistency of therapist
Insurance panels may drop and add providers regularly. Choosing an out-of-network therapist removes the risk that your plan will suddenly stop covering your therapist the following year.

Focus stays on the work
Direct payment keeps the relationship straightforward. There are no surprise denials, no appeals, and no need to justify continued treatment to a case reviewer.