Superbill Support

Questions to Ask Your Insurer

(Call the number on the back of your insurance card, and ask for

the behavioral health or mental health benefits line.)

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1) Do I have out-of-network benefits for outpatient mental health/behavioral health

services? Is that different from my in-network benefits, and if so, how?

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2) What is my out-of-network deductible, and how much of it have I already met this year?Once I’ve met it, what percentage of the fee gets reimbursed? Is reimbursement

based on what I was charged, or an “allowed amount” or the “usual and

customary rate” the insurer sets?

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3) Is there a separate out-of-pocket maximum, and does out-of-network mental health carecount toward it?

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4) Do I need referral or pre-authorization before starting therapy?

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5) Is there a cap on the number of sessions per year for outpatient therapy?

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6) Do you cover CPT codes 90837 or 90834?

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7) Is telehealth reimbursed the same as in-person sessions?

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8) How do I submit the claim for reimbursement (mail, fax, or an online portal)?

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9) What’s the deadline for submitting after the date of service?

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10) What information does the superbill need to include for the claim to be processed?

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11) How long does reimbursement usually take, and does it come to me directly?

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Tip: Write down the date, representative’s name, and a reference or call-confirmation number to help you if a claim gets disputed later.