How to use a super bill for potential reimbursement for therapy
Everything you need to know about using a super bill to receive potential reimbursement from your health insurance for your therapy
Therapy is an investment you make in your mental health, your wellbeing, and your relationships. If you have questions about using your insurance for therapy, keep reading to explore some of our Frequently Asked Questions or call us today at 985-441-7550.
How do I use my insurance with Revive Counseling and Consulting LLC?
At this time, we do not accept any insurance meaning you would pay us directly for online therapy services and your card on file is charged after each session. That would make us an “out of network provider” according to your insurance meaning we are not contracted with your insurance and reimbursement is not guaranteed unless specifically outlined in your policy. We can, however, provide you with a super bill that you can submit to your insurance for possible partial reimbursement. If you are hoping to be reimbursed for counseling, we encourage you to call your insurance directly to inquire about your out of network coverage before beginning services with Revive. Please keep in mind that if you would prefer to find an in-network provider, we will assist you in that referral at any time.
What questions should I ask my insurance before starting services with Revive Counseling and Consulting LLC if I want to use my insurance?
Call the number on the back of your health insurance card and ask for “member services. Be sure to ask these questions to verify out-of-network coverage:
Do I have out-of-network coverage for mental health services provided through telehealth?
What is my yearly deductible? Has it been met or how much more until my deductible is met?
How many sessions per year does my plan cover?
How much does my insurance plan reimburse for an out-of-network provider for CPT codes 90834 and 90837?*
Does my insurance plan cover Z codes for couples therapy*?
What is my co-payment (if applicable)?
Do I need prior authorization?
Do I need approval from my primary care provider?
What is the home and mailing address on my file? (important to ensure checks are issued to the correct address)
How do I submit a super bill? Is there an online portal or do I have to mail or fax a copy?
What is the time limit to submit a super bill?
*CPT codes refer to the type of service you received. CPT code 90834 refers to a clinical 45 minute session and CPT code 90837 refers to a clinical 60 minute session (a clinical hour is typically 53 minutes to allow time for documentation) with a modifier (02) after the code to indicate services took place over teletherapy.
*Z codes are typically not covered by insurance. These codes can include Problems Related to Employment and Unemployment (Z56) Z56.0, Problems Related to Housing and Economic Circumstances (Z59) Z59.0, and Problems in Relationship with Spouse or Partner Z63. 0. For this reason, couples therapy is not typically covered by insurance but be sure to check with your insurance about your specific out of network coverage.
What is a super bill?
A super bill is a document, like an invoice or receipt, that outlines the services you received with your therapist. It is generated by our electronic health system and sent to you automatically on a monthly basis. It must include the following information in order to be considered for reimbursement:
Client name, address, and date of birth
Therapist name, phone number, and email
Therapist Tax ID and National Provider Identifier (NPI)
Statement number and date issued to client
A diagnosis and diagnosis code (also called a CPT code)
Service type, date, and code for reimbursement
The fees that you paid
This is a sample super bill below that we use at Revive:
What are some points to consider before I decide to submit a super bill to my insurance?
When exploring your options for reimbursement, keep these points in mind:
Reimbursement requires a diagnosis - a super bill, just like any other paperwork submitted to insurance for reimbursement, requires a clinical diagnosis as classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) and the International Classification of Diseases (ICD-10). Examples of diagnoses and their codes can include:
Adjustment disorder, With depressed mood (F43.21)
Bipolar I disorder, Current or most recent episode depressed, In partial remission (F31.75)
Cannabis use disorder, Mild (F12.10)
Posttraumatic stress disorder (F43.10)
And many more...
If you have continuing questions about your diagnosis or have concerns about receiving a diagnosis, please bring this up to your therapist.
Insurance does not typically reimburse couples therapy - Your insurance requires a diagnosis to prove that your therapy is “medically necessary” not just that you are experiencing grief or having issues in your relationship. For this reason, couples therapy is not typically reimbursed by insurance providers. Talk to your insurance and therapist about specific coverage for couples therapy.
How do I submit my super bill?
Insurances typically have a time limit to turn in your super bill of 90 days or more, some up to 180 days. This can fall under “timely filing”. To submit your super bill, contact your insurance company and ask for “member services” or check their website for instructions. There are usually 3 options for turning in a super bill: mail, fax, or through an online portal.
Mail - you can ask your insurance for an address to mail the super bill. Make sure you allow time for delivery to stay within your limit for timely filing.
Fax - if you would like to keep your protected health information private, we suggest not faxing from a public fax machine (such as at the library) or a work fax machine. The receipt that shows your fax was sent will include this private health information.
Online portal - most insurance providers will have an online portal through which you can upload your super bill. It is the most secure option to send your super bill as the website will request a login or password. It is also faster than mail or fax. Be sure to ask your insurance about this option.
What can you expect after you submit a super bill?
Insurance companies typically have a time limit in which you can submit a super bill. If you submit your super bill after this time limit, you risk losing any potential reimbursement.
It can typically take your health insurance 2-4 weeks to process your super bill. They will either pay the full amount of services minus your copay, or they will put this amount towards your deductible. If your super bill is denied, call your insurance and request information about the denial.
Want to know more about how online therapy works with Revive Counseling and Consulting?
Call us today at 985-441-7550 or email us at contact@revivepractice.com for your free 15 minute consultation to explore your options.
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