Understanding Superbills

What is a Superbill

A superbill is a detailed receipt for your therapy sessions. You send it to your insurance so they can review your out of network benefits and reimburse you directly. Everyone’s plans and benefits are different.

Quick Summary

  • Superbills apply to clients who have out of network mental health benefits, typically through a PPO plan.

  • A superbill is a detailed receipt that you submit to your health insurance for possible reimbursement.

  • You pay your therapist directly and receive reimbursement from your insurance company.

  • Your insurer will reimburse you according to your out of network benefits.

  • We provide monthly superbills for clients.

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Step by Step Submission Guide: How Insurers Actually Process Claims

  1. Download the superbill we sent you as a PDF.

  2. Log in to your insurance member portal. Look for Submit a claim.

  3. Select Out of Network professional service.

  4. Upload the superbill and any requested forms.

  5. Submit. Save your confirmation number.

  6. Processing often takes two to six weeks depending on the plan.

  7. Reimbursement typically arrives by check in the mail or direct deposit if your plan offers it.

If your plan requires mail or fax use the address on the back of your card. Many plans now accept mobile uploads.

How To Check Your Benefits

understanding superbills

Call the number on your insurance card or log in to your member portal and ask the questions below. You can copy and paste this script.

Script:

Hello. I am seeking psychotherapy with an out of network licensed provider in California. Can you help me check my out of network benefits.

  • Do I have out-of-network benefits for individual therapy, specifically for CPT codes 90834 and 90837?

  • What is my out-of-network deductible, and how much of it have I already met?

  • After I meet my deductible, what percentage of the allowed amount do you reimburse?

  • Do I need pre-authorization before starting therapy?

  • Do you cover telehealth sessions for psychotherapy when billed with POS 10?

  • How do I submit a superbill, and how long does reimbursement usually take?

Common Insurance Terms Explained

Term Plain Language Meaning
Deductible The amount you pay out of pocket each year before your insurance begins sharing costs.
Coinsurance The percentage you are responsible for after meeting your deductible.
Allowed Amount The number your insurer uses to calculate reimbursement. This is usually lower than the session fee.
Out-of-Network (OON) Services provided by clinicians who are not contracted with your insurance. Usually part of PPO plans.
Medical Necessity The clinical reason your insurer requires to cover care.
Explanation of Benefits (EOB) A statement from your insurer showing how your claim was processed.