How to Use a Super Bill for Potential Reimbursement in Therapy

Starting Therapy

By Elizabeth Mahaney, LMHC, MFT, CCTP, NCC, Ph.D.

Learn all about leveraging a super bill to maximize insurance reimbursement for your counseling sessions at South Tampa Therapy.

Counseling is a vital investment in your mental health, well-being, and interpersonal connections. If you're curious about utilizing insurance coverage for therapy, continue reading to discover our FAQs or reach out to us at 813-240-3237.

How to Utilize Insurance with South Tampa Therapy:

At South Tampa Therapy, we only accept United, Aetna, and Cigna. We also presently do not accept insurance directly from any other insurance company. Instead, clients pay for online or in person therapy sessions upfront, with charges processed via their card on file. As an out-of-network provider, reimbursement isn't guaranteed unless explicitly outlined in your policy. However, we provide a super bill for potential partial reimbursement. Before commencing services, we advise contacting your insurance to inquire about out-of-network coverage. Should you prefer an in-network provider, we're happy to assist with referrals.

Key Questions to Ask Your Insurance Before Starting with South Tampa Therapy:

Contact your insurance's member services and inquire about out-of-network coverage for telehealth mental health services. Clarify:

• Deductible status and amount remaining.

• Coverage limit for sessions annually.

• Reimbursement rates for CPT codes 90834 and 90837.

• Coverage for Z codes pertaining to couples therapy.

• Co-payment details (if applicable).

• Requirements for prior authorization or primary care provider approval.

• Super bill submission process, including deadlines.

• Correct address for reimbursement checks.

Understanding the Super Bill:

A super bill serves as a detailed record of therapy services received, facilitating potential reimbursement. It must include:

• Client and therapist details.

• Statement number and issuance date.

• Diagnosis and corresponding code.

• Service specifics and fees paid.

Points to Consider Before Submitting a Super Bill:

• Reimbursement necessitates a clinical diagnosis from DSM–5 or ICD-10.

• Couples therapy may not be reimbursed by insurance due to diagnostic requirements.

• Discuss any diagnosis-related concerns with your therapist.

Submitting Your Super Bill:

Most insurers mandate submitting super bills within 90 to 180 days to meet timely filing requirements. Options include:

1. Mail: Obtain the insurer's mailing address and allow ample time for delivery.

2. Fax: Ensure privacy by avoiding public or work fax machines.

3. Online Portal: Utilize the insurer's secure portal for faster submission.

Post-Submission Expectations:

Insurers typically take 2-4 weeks to process super bills. Reimbursement may cover session costs minus co-pays or contribute towards deductibles. In case of denial, contact your insurer for clarification.

By optimizing your understanding of super bills and insurance processes, you can navigate potential reimbursement for therapy sessions effectively. For further assistance, reach out to South Tampa Therapy 813-240-3237.