Filing Out-of-Network

Benefits of Using an Out-of-Network Therapist 

We are out of network with all insurance providers. A superbill can be provided for you to submit to your health insurance for reimbursement of potential out-of-network benefits.  

There are many benefits to seeing an out-of-network therapist. Here are a few reasons why you might want to consider this option:

Greater flexibility in choosing a therapist: When you see an out-of-network therapist, you have the freedom to choose from a wider pool of professionals. This can be especially helpful if you’re looking for a therapist with a specific area of expertise or if you live in an area with a limited number of in-network providers.

More control over your treatment: An out-of-network therapist is typically not bound by the same restrictions as in-network providers. This means that you have more control over the type of treatment you receive and how often you see your therapist.

Cost savings: While you may have to pay more out of pocket for an out-of-network therapist, you may ultimately save money in the long run. This is because you may be able to negotiate a lower rate with an out-of-network therapist, and you may also be able to avoid the additional fees associated with seeing an in-network provider.

Privacy: Out-of-network therapists are not required to report to insurance companies, this can be an advantage for people who want to keep their therapy sessions private.

Quality of care: Some individuals may find that they receive higher quality care from an out-of-network therapist because they are not bound by the same restrictions as in-network providers.

Specialized treatment: Out-of-network therapists may have specialized training in specific areas of treatment, such as trauma, eating disorders, or addiction.  

Overall, seeking out an out-of-network therapist can offer many benefits including flexibility, control over treatment, cost savings, privacy and specialized treatment. 

    How to file out-of-network benefits 

    We are out of network with all insurance providers. A superbill can be provided for you to submit to your health insurance for reimbursement of potential out-of-network benefits.

    What does out-of-network mean?

    We are out of network with all insurance providers. This means that neither C&C Betterworks nor our providers have a contract with any health insurance providers. 

    What is a superbill?

    A superbill is also known as a Statement for Insurance Reimbursement. This is a document with an itemized list of services provided by your C&C Betterworks provider.

    The essential pieces you will need to submit the claim are the diagnosis code, your name and date of birth, CPT codes and descriptions for the services you received, the amount charged, payments received, and reimbursement recipient.  

    What are out-of-network benefits?

    Out-of-network benefits are included in your insurance plan for services you receive from providers not contracted with your health insurance plan providers. 

    Will I have a deductible?

    Just as you have a deductible for your in-network benefits, you likely have a deductible for out-of-network benefits. 

    How do I get reimbursed?

    You will submit your superbill to your insurance company to be reimbursed for out-of-network benefits.

    These claims are between you and your insurance company, so C&C Betterworks and its providers cannot submit the claim for you. The reimbursement from your insurance company will be sent directly to you. 

    How much will I be reimbursed?

    The amount that you are reimbursed will depend upon your out-of-network benefits. You may not be refunded for the total amount you paid for your services. 

    What do I need to do to receive a superbill from C&C Betterworks, P.A.?

    Please let us know if you intend to submit a superbill to your insurance company for potential out-of-network benefits. Providers cannot provide superbills for sliding scale payments. 

    We recommend contacting your insurance company before submitting for potential out-of-network benefits.

    Here are some questions that might be helpful to ask: 

    • Do you accept out-of-network claims for psychotherapy?  
    • What is my annual out-of-network deductible for mental health services, and does this include my other medical expenses?  
    • What is my coinsurance rate? (If you have coinsurance, this is the percentage of each session fee your insurance will likely reimburse you after you have met your deductible for the year.) 
    • What is my out-of-pocket maximum?  
    • How many sessions am I able to receive? (Some insurance companies have a limit to how many therapy sessions they will cover.) 
    • What is the best way for me to submit a claim? (Often, insurance companies have a form you will fill out and mail in, along with your superbill. We recommend making copies of all paperwork you send to your insurance company.)