verifying benefits
We strive to provide the best care possible.
For this reason, we have chosen to operate as an out-of-network provider. As an out-of-network provider, we are able to better serve you without the limitations of insurance companies, such as session frequency, length of care, or compromising confidentiality.
We value honesty and transparency here at Blueprint Therapy and Wellness, so we encourage all prospective clients to verify their insurance benefits before working with us. We want you to have the information needed to make an informed decision on whether our services are right for you, without surprise billing fees. Depending on your individual plan’s out-of-network benefits, you may be eligible to receive full or partial reimbursement for session fees. Insurance companies will typically reimburse between 60-90% of therapy costs, with some plans up to 100% - it just depends on what your individual plan is!
Navigating these insurance benefits can be confusing, so we’re here to help.
Below is a step-by-step guide on how to navigate verifying your out-of-network benefits.
Step One: Contact your insurance company
Call your insurance company member services line listed on the back of your insurance card. You can also access your insurance benefits through your online members only portal.
Step Two: Check on your out-of-network benefits
Typically, if you have a PPO or POS insurance plan, you will have out-of-network benefits. The specifics of these out-of-network benefits can be found in your Summary of Benefits. An insurance representative can send this benefits packet to you, or you may have received it during your open enrollment period. It can also be found on most insurance company websites.
Step Three: Ask about your out-of-network deductible
Similar to an in-network deductible, an out-of-network deductible is the amount of money you will pay before you are eligible for reimbursement. If you’ve used out-of-network benefits before, ask your insurance representative how much of your out-of-network deductible has been met.
Step Four: Find out how much your plan will reimburse
Your out-of-network coinsurance is the percentage / amount of session costs you will be responsible for, similarly structured to an in-network copay. It may be helpful to also ask if your insurance company has a reimbursement maximum (whether there is a cap on how much you will be reimbursed for session costs).
At the end of each month, our Billing team will send you a personalized Superbill.
This Superbill (more like a Super-Receipt) will reflect how many sessions you’ve had and therapy fees paid. Our team will work to ensure this documentation has the information your insurance company needs in order to reimburse you accurately.
After receiving this monthly Superbill, you will submit it to your insurance company directly. Insurance companies typically take a few days to process the claim, and you will soon receive a mailed check with your reimbursement.
For more information on this process, Zencare offers a great overview on out-of-network benefits.