Out-of-network reimbursement guide
Most PPO plans cover 60–80% of out-of-network therapy fees. Here’s exactly what to do — most clients spend about 10 minutes a month on this.
The same flow works for every PPO. We do step 1; you do steps 2–4.
Email us to request your superbill — an itemized PDF receipt with the diagnosis code, CPT code, dates of service, and Rose’s NPI and tax ID. We send it the same business day.
Log in to your insurance member portal and look for "Claims" or "Submit a claim." Most plans accept out-of-network claims as a PDF upload. We list direct links to each major insurer below.
Fill in your name, member ID, and the date(s) of service from the bill, then attach the PDF. The whole submission usually takes ~10 minutes a month.
Reimbursement lands as a paper check or direct deposit. You can track the claim’s status through the same member portal.
Links to the major PPOs in each state we’re licensed in.
On each insurer’s site: log in to your member account, then search “Out-of-network claim” or “Submit a claim” to find the right form. (We link to home pages because insurers shuffle deep links every few months — home pages stay put.)
Don’t see your insurer? Most plans accept out-of-network claims the same way — log in and search “Submit a claim” on your member portal.
Most denials are coding mismatches, missing referrals, or a plan that doesn’t cover telehealth as out-of-network. Call the number on the back of your insurance card and ask why — most issues are a one-call fix. If you’d like the denial letter looked at, paste the text into your next session and we can talk it through together.
Yes. Therapy with a licensed clinician is a qualified medical expense for HSA and FSA accounts. You can pay with your HSA/FSA card directly, or pay by credit card and submit our receipt to your HSA/FSA administrator for reimbursement.
HMO and government plans (Medi-Cal, MaineCare, Green Mountain Care, Medicaid, Medicare) typically don’t reimburse for out-of-network providers. If that’s your situation, an in-network clinician through your plan is usually the more accessible route. Happy to talk through it on the free consult.
Call the member services number on the back of your insurance card and ask: "Do I have out-of-network mental health benefits? What’s my deductible, and what percentage do you reimburse for CPT code 90837 after the deductible is met?" That gives you the three numbers you need to estimate your reimbursement.
Unusual situation we don’t cover here? Email insurance@getbetterthoughts.com — we answer when we can (not staffed daily).
More general questions? Read the full FAQ → or see pricing →.
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