Everything you need to know about using a super bill to receive potential reimbursement from your health insurance for your physical therapy.
How do I use my insurance Koda Physical Therapy?
At this time, we do not accept any insurance meaning you would pay us directly for online therapy services and your card on file is charged after each session. That would make us an “out of network provider” according to your insurance meaning we are not contracted with your insurance and reimbursement is not guaranteed unless specifically outlined in your policy. We can, however, provide you with a super bill that you can submit to your insurance for possible partial reimbursement. If you are hoping to be reimbursed for counseling, we encourage you to call your insurance directly to inquire about your out of network coverage before beginning services with Revive. Please keep in mind that if you would prefer to find an in-network provider, we will assist you in that referral at any time.
What questions should I ask my insurance before starting services with Revive Counseling and Consulting LLC if I want to use my insurance?
Call the number on the back of your health insurance card and ask for “member services. Be sure to ask these questions to verify out-of-network coverage:
- Do I have out-of-network coverage for mental health services provided through telehealth?
- What is my yearly deductible? Has it been met or how much more until my deductible is met?
- How many sessions per year does my plan cover?
- How much does my insurance plan reimburse for an out-of-network provider for CPT codes 90834 and 90837?*
- Does my insurance plan cover Z codes for couples therapy*?
- What is my co-payment (if applicable)?
- Do I need prior authorization?
- Do I need approval from my primary care provider?
- What is the home and mailing address on my file? (important to ensure checks are issued to the correct address)
- How do I submit a super bill? Is there an online portal or do I have to mail or fax a copy?
- What is the time limit to submit a super bill?
What is a super bill?
A super bill is a document, like an invoice or receipt, that outlines the services you received with your therapist. It is generated by our electronic health system and sent to you automatically on a monthly basis. It must include the following information in order to be considered for reimbursement:
- Client name, address, and date of birth
- Therapist name, phone number, and email
- Therapist Tax ID and National Provider Identifier (NPI)
- Statement number and date issued to client
- A diagnosis and diagnosis code (also called a CPT code)
- Service type, date, and code for reimbursement
- The fees that you paid
This is a sample super bill below that we use at Revive:
How do I submit my super bill?
Insurances typically have a time limit to turn in your super bill of 90 days or more, some up to 180 days. This can fall under “timely filing”. To submit your super bill, contact your insurance company and ask for “member services” or check their website for instructions. There are usually 3 options for turning in a super bill: mail, fax, or through an online portal.
- Mail – you can ask your insurance for an address to mail the super bill. Make sure you allow time for delivery to stay within your limit for timely filing.
- Fax – if you would like to keep your protected health information private, we suggest not faxing from a public fax machine (such as at the library) or a work fax machine. The receipt that shows your fax was sent will include this private health information.
- Online portal – most insurance providers will have an online portal through which you can upload your super bill. It is the most secure option to send your super bill as the website will request a login or password. It is also faster than mail or fax. Be sure to ask your insurance about this option.
What can you expect after you submit a super bill?
Insurance companies typically have a time limit in which you can submit a super bill. If you submit your super bill after this time limit, you risk losing any potential reimbursement.
It can typically take your health insurance 2-4 weeks to process your super bill. They will either pay the full amount of services minus your copay, or they will put this amount towards your deductible. If your super bill is denied, call your insurance and request information about the denial.
Want to know more about how online therapy works with Revive Counseling and Consulting?
Call us today at 985-441-7550 or email us at contact@revivepractice.com for your free 15 minute consultation to explore your options.
