Superbill 101: A Guide to Out-of-network mental health reimbursement
What is a Superbill?
Before we dive in, let’s explain what “out-of-network” means.
Health insurance companies separate providers into two categories:
In-network providers have a contract with your insurance company. This means billing the insurance is done by the clinic or clinician, and costs are usually lower for patients.
Out-of-network providers do not have that contract. Some out-of-network providers will still directly bill the insurance company on your behalf, but this is rare because without a contract in place, it is difficult to accurately assess what the cost for the patient will be ahead of time and most clinics want to provide their patients with a cost quote prior to starting services. Aspire Psychology will not bill out-of-network insurance plans directly, which means that in order to use your out-of-network benefits, you would pay the full out of pocket fee at the time of service and then submit documentation (like a superbill) to your insurance company to request reimbursement.
A superbill is a detailed receipt for your mental health services. It contains all the information your insurance company needs to consider your claim and possibly pay you back for part of your costs. A Superbill includes details such as your diagnosis, the billing code the provider chose to best represent the service you received, your contact information, and the amount you paid for the service. Think of it as a bridge between your mental health service provider and your insurance that describes all the information the insurance company would normally receive on a claim sent by your service provider.
Why Use a Superbill for Out-of-Network Mental Health Care?
Many people choose out-of-network mental health providers because they want:
More choice in who they work with - specialized services are often difficult to find when limited by insurance companies.
Established trust with a provider recommended by a friend, family member, or another professional.
Continuing care with a provider even though insurance has changed.
While you do pay up front, submitting a superbill to your insurance can help you recover some or most of those costs. The reimbursement amount varies depending on your insurance plan’s out-of-network coverage which you can check ahead of time by contacting the member service department of your insurance plan.
How to Get a Superbill for Mental Health Services
At Aspire Psychology, our billing team provides a monthly superbill automatically for all patients who have an out-of-network plan with all the details you need to submit to your insurance company.
A superbill includes the key details your insurance company needs in order to consider reimbursing you for your mental health services. Typically, it contains:
Your information – your full name and date of birth
Your provider’s information – their name, professional license, and a unique ID number (called an NPI)
The purpose of the service – this is shown through a “diagnosis code” which is a number that corresponds with why you were seen, such as anxiety or depression
The type of service – this appears as a “procedure code” that insurance companies use to know what kind of service you had, like an individual therapy session
The dates of your appointments and the fees charged
Proof of payment
You don’t need to know all of these details yourself—your mental health service provider fills them in for you. All you have to do is submit the superbill to your insurance. Many insurance companies allow you to submit claims easily through their portals and apps so that submitting a superbill on a monthly basis can be completed in a matter of minutes!
How to Submit a Superbill for Insurance Reimbursement
Here’s the typical process:
Pay for your mental health services up front.
Submit your superbill (and any required claim forms) to your insurance via their preferred submission method. If you are unsure how your plan prefers that superbills be submitted, you can reach out to the member services department.
Wait for processing—most companies take 2–4 weeks to complete processing and send you the reimbursements. You will usually know within days if your submission has been accepted or rejected and if your submission is ever rejected, your insurance company should explain why and what can be done to ensure acceptance when you resubmit the superbill.
Superbill Checklist
✅ Confirm your out-of-network benefits with your insurance before agreeing to services with an out-of-network provider
✅ Start services and pay for mental health services as appointments happen
✅ Receive your monthly superbill from Aspire Psychology in the patient portal
✅ Submit it (and any required forms) to your insurance
✅ Track your claim and reimbursement status to ensure a timely reimbursement
FAQs About Superbills
Do all insurance plans accept superbills?
Not all plans reimburse for out-of-network services but those who do provide out-of-network benefits accept superbills. Call your insurance company to ask if they cover out-of-network mental health services. It can be helpful to mention that the services will be for outpatient mental health in an office setting.
How much will I get reimbursed?
Reimbursement depends on your specific plan. Some cover a large portion, while others reimburse a smaller percentage—or none at all. If your plan covers a percentage, you can get a rough estimate of what they will help with by applying that percentage to the out of pocket rate you will be paying for mental health services. Out-of-network insurance companies set their own reimbursement rates, which means they are unlikely to use the full out of pocket rate to determine the percentage they will pay.
How long does reimbursement take?
Most insurance companies process superbill claims within 2–4 weeks. Delays can happen if paperwork is incomplete or a superbill needs to be resubmitted.
Do I need a separate superbill for every session?
No. In order to receive reimbursement for all appointments, you will need each appointment listed on a superbill. But, one superbill can list multiple appointments so that you do not need to remember to submit superbills every week. At Aspire Psychology, we provide one superbill each month that covers all your sessions from that month.
What if my claim is denied?
This may happen and is usually fixable. You can correct missing details, resubmit, or call your insurance company for clarification. Our Billing Specialist is happy to help make any clinically appropriate adjustments needed on superbills to get them approved. We do our best at Aspire Psychology to make sure superbills are accurate and detailed the first time so that resubmission is rare.
Still Have Questions?
Every insurance plan is different. We encourage you to call your insurance company to confirm your specific out-of-network benefits and the preferred superbill submission method. You can also email us with any questions.
It can feel discouraging and intimidating to be told that you will have to pay for all services upfront in order to see a provider that specializes in exactly what you need. Unfortunately, this is especially common in the mental health industry, and it can be tempting to forgo mental health treatment because you cannot find the right fit within your insurance plan’s network.
At Aspire Psychology, our team is dedicated to making the billing process as stress-free as possible and ensuring you feel confident about getting the best care available. In many cases, submitting superbills to your insurance is the most affordable option for high quality mental health services and Aspire Psychology will make this often unfamiliar process accessible to you.
Get Started
If you’ve already figured out your out-of-network benefits, and want specialized care now, schedule an appointment with us. Our team will provide you with top-tier support every step of the way.
