Superbill and Out-of-Network
Benefits
If you'd like to use your health insurance for our services, you may be able to get part of your payment back. This page explains what a superbill is, how to check your benefits, and how to submit your claim.
What is a superbill?
A superbill is an itemized receipt for the services you received. It has the details your insurance company needs to process a claim and reimburse you, if your plan covers out-of-network care.
What it includes:
Provider Details
Name, address, license number, and NPI (national provider identifier) number
Date of Service
Each date you were seen
Procedure Code(s)
CPT codes describing the service provided
Your Details
Name, date of birth, and address
Diagnosis Codes
ICD-10 codes describing the reason for care
Fee and Payments
The amount charged and the amount you paid
* A superbill is not a claim that we file for you. You submit it to your insurance company yourself, and they send any reimbursement to you.
How to find out if you have out-of-network benefits
Not every plan covers out-of-network care, and coverage varies widely. The only reliable way to know is to ask your insurance company directly.
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Find your member services number. It's on the back of your insurance card. You can also log in to your insurer's member portal and look for "benefits" or "coverage."
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Call and ask the questions below. Write down the date, the representative's name, and a call reference number.
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Ask for the answers in writing. If they can, have them send a confirmation through the portal or by email.
Questions to ask your insurance company
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Does my plan include out-of-network benefits for outpatient services?
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Is there a separate out-of-network deductible?
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How much of it have I met this year?
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What percentage of the cost will be reimbursed after I meet the deductible (coinsurance)?
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Is reimbursement based on my provider's fee, or on an "allowed amount" or "usual and customary" rate?
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Is there a limit on the number of visits per year, or does a service need prior authorization or a referral?
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Is there an out-of-network out-of-pocket maximum?
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How do I submit a claim, and what is the deadline (timely filing limit)?
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Where do I send it: an online portal, fax, or mailing address?
* Ask about coverage for the specific type of service you receive from us, since some plans treat categories of care differently. Also ask whether your plan is a PPO, POS, or HMO. PPO and POS plans are more likely to include out-of-network coverage, while many HMO and EPO plans do not.
How to submit your superbill
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Pay for your session. Superbills reflect services you've paid for. We'll issue one after payment is received
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Get your superbill from us. Request it after your visit or at the end of each month. Let us know if you'd like one sent regularly.
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Find your insurer's claim form. Many insurers have a "member claim form" or "out-of-network reimbursement form" in the member portal or on their website. Some accept a superbill alone.
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Complete the form. Enter your member ID, group number, and personal details exactly as they appear on your insurance card. Double-check that names and dates match your superbill.
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Attach your superbill. Include the superbill and any other documents the insurer asks for, such as proof of payment.
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Submit it. Use the portal, mail, or fax, depending on the insurer's instructions. Keep a copy of everything you send and save a confirmation or tracking number.
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Follow up. Processing usually takes a few weeks. If you don't hear back, contact your insurer with your claim or reference number. Reimbursement is typically sent to you by check or direct deposit, along with an explanation of benefits (EOB).
* Submit promptly. Most insurers set a deadline for claims, often 90 days to one year from the date of service. Submitting monthly, or right after you receive each superbill, helps you stay within it.
Common Questions
Is reimbursement guaranteed?
No. Reimbursement depends on your plan, your deductible, and your insurer's rules. We can't guarantee coverage or a specific amount. Confirm your benefits before you start.
Can you submit the claim for me?
We provide the superbill so that you can submit your claim. Reimbursement is paid to you, and you are responsible for our fees at the time of service.
What if my claim is denied?
Read the explanation of benefits to see why. Common reasons are an unmet deductible, missing information, or a coding question. You can call your insurer, correct any errors, and appeal. Contact us if a fix is needed on the superbill.
How often can I get a superbill?
You can request one after any visit, or at the end of the month covering all of your visits. Just let us know what works best.