Out-of-Network Guide

Authentically Living Psychological Services, PLLC is an out-of-network provider and does not accept insurance. This means we are not paneled with insurance companies and payment is expected at the time of treatment.

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Why we have chosen to be an out-of-network provider:

1. It compromises confidentiality: Insurance companies can request notes to deem whether therapy is “medically necessary.”

2. Insurance companies require diagnosis: Regardless of whether a client qualifies for a diagnosis, insurance companies require a diagnosis code for clients to receive therapy services.

3. Limited treatment control: Many insurance companies limit the time allotted for therapy services to a specific number of sessions.

4. Time commitment: Submitting claims to insurance companies take considerable time. Spending time managing insurance claims is less time our practice gets to spend with our clients.

5. Poor reimbursement: Insurance companies dictate how much reimbursement clinicians receive for their time, regardless of service fees.

6. Client commitment & accountability: Clients who are willing to make the investment in therapy are often more committed, and as a result, take more accountability for their wellness.

7. Client Reimbursement: Many insurance companies with out-of-network benefits reimburse clients 50-80% of the cost of each session. 

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If you are interested in using out-of-network benefits, please follow the guide below:

The practice provides a monthly superbill that can be submitted to the insurance company to receive reimbursement directly to the client for services received. 

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1. Call the 1-800 number on the back of the insurance card. 
2. Use the automated system menu to navigate to “mental health out of network benefits” or press 0 to speak to an insurance representative. 
3. Ask the following questions: 
a. Does the insurance plan have out-of-network outpatient mental health coverage? Can the benefits be used towards telehealth with a Licensed Clinical Psychologist? 
b. Is there an out-of-network deductible that needs to be met before receiving reimbursement? 
c. If so, how much of the deductible has been met this year? 
d. What amount will be reimbursed per session?
e. How long will it take to receive reimbursement? 

f. How to submit superbill?
g. Is a referral needed from an in-network provider to see someone out-of-network?