We are currently in-network with Cigna Behavioral Health. For all other insurance holders, we do assist families with processing out-of-network benefits; many individuals we work with receive 80%-100% of their services covered by insurance. For any services we offer, we will provide you with the necessary documentation for reimbursement (if your insurance company offers out-of-network coverage). We encourage you to contact your insurance company so you have a firm understanding of your coverage. See FAQs below for more information about filing insurance claims for out-of-network providers
Frequently Asked Questions About Insurance
Q: What is an out-of-network claim?
A: An out-of-network claim is a request for your health insurance company to reimburse a bill from a provider that does not have a negotiated contract with your health insurance company.
If you are billed for the full cost of a visit directly by your provider, or they have told you they do not accept insurance, it is likely they are out-of-network.
Q: Do all health insurance policies reimburse out-of-network claims?
A: No, not all policies reimburse out-of-network claims. Check with your insurance provider to see if your plan has out-of-network benefits.
Typically, a PPO or a POS type plan will have some type of out-of-network coverage, while most HMO and EMO plans only reimburse for out-of-network care in the case of an emergency.
Q: How much money will I get back?
A: This depends on your specific insurance plan, your deductible and the type of medical service you received.
Q: What data should be on the out-of-network claim I submit for reimbursement?
A: To process your claim your bill will need to include your name, your provider’s name, your provider’s employment identification number (EIN or TIN) or social security number, your provider’s National Provider Identifier number, the code(s) for your diagnosis, the code(s) for any procedures, the date of your appointment (date of service), and the total amount of the bill.
A bill with all this information is called a “superbill.”