Superbill – what is it and why do I need one?

Using your insurance to pay for therapy

While the term “superbill” may bring to mind images of capes, spandex suits, and heroes saving the city, the reality is much more practical (and yes, has far less spandex involved).

What is a superbill?

In the context of therapy, a superbill is essentially an itemized document that contains the basic information your insurance company would need to decide whether they will reimburse you for therapy costs you’ve incurred. This is different from a therapist billing your insurance directly, because the superbill is provided to you (the client), so you can submit it to your insurance provider. This allows for more affordable therapy. Your insurance may cover part, all, or (unfortunately) none of your price per session. But, you won’t find out unless you ask them!

At Estes Therapy, we are able to generate and provide superbills for individual therapy, couples therapy, child therapy, family therapy, and group therapy.

What is an out-of-network provider?

An out-of-network provider is someone who is not paneled with your insurance provider. When you choose to work with an out-of-network therapist, you are responsible for the full fee out of pocket, and the insurance panel may be able to reimburse you directly, providing you submit the superbill to them. So why work with an out-of-network provider? An out-of-network provider, like the therapists here at Estes Therapy, may have the expertise you are looking for. Our founder, Jennine Powell, has worked hard to ensure that each and every therapist on our team is highly trained and works to get to the root of any issue. Many in-network therapists might also fall under that description – but we can only speak to our team’s credentials! Additionally, it can be really hard to get weekly, biweekly, or even monthly sessions depending on your provider.    

Do all insurance policies provide reimbursement? 

It entirely depends on your specific insurance policy. Some policies do not offer any out-of-network benefits, some will reimburse partial amounts, while others offer full coverage for out-of-network therapy appointments.

Why would I want a superbill?

Sometimes, insurance providers will reimburse fully or partially for therapy sessions. This might include individual therapy, couples therapy, family therapy, child therapy, or group therapy. So basically, you might be able to cut down on your therapy costs! How cool is that?

What information does the superbill contain?

The superbill will contain your name, address, and contact info, as well as your therapist’s name, work address, and contact info. It will also include your therapist’s license type and number, NPI number, and tax ID number. The superbill will also reflect any official diagnoses, type of service provided, and the total costs paid by you.

How do I know if my insurance will reimburse?

You’ll have to call your insurance provider directly. Your therapist will not be involved with talking to your insurance company and asking for reimbursement information. Here are some questions you can ask your insurance provider:

  • “Do you reimburse for out-of-network psychotherapy services?”
    •  Note: Be sure to specify whether you’re looking for reimbursement for individual, couples, children, family, or group therapy!
  • “Do you require a diagnosis to reimburse for out-of-network services? If so, what diagnoses are/aren’t covered?”
  • “How/where can I submit the superbill once I receive it from my therapist?”

Okay… I want to work with an out-of-network provider. How do I get my hands on a superbill for my counseling sessions?

Here at Estes Therapy, all you have to do is ask. All of our therapists are happy to generate superbills for your sessions. Just shoot your therapist an email, give them a call, let them know if your next session, or ask one of our office managers by calling our main line: (619) 558-0001. We know how important your mental, social, and relational health is and we will always do what we can to ensure services are as accessible as possible.

 

If you have any additional questions, please always feel free to reach out to us. We’re here for you!