We understand that filing out-of-network claims can feel overwhelming, but we’re here to help make the process easier. Below are some resources and tools to assist you in submitting claims to your insurance provider for reimbursement.
1. Understand Your Benefits
Before initiating services and/or filing a claim, contact your insurance company to confirm:
- If your plan covers out-of-network mental health services. Be sure to be specific and ask about the service you will be receiving (individual, family, couples, group therapy, or psychological testing services)
- What percentage of the fees they reimburse
- If there’s a deductible you must meet first
If you’re unsure where to start, you can review The Complete Guide to Out-of-Network Reimbursement.
2. Request Your Superbill
We provide superbills at any time by request. Please visit our website and navigate to “Get Started” and “Request Your Superbill” to submit a request. You can also request a superbill by:
- Calling our office at (804) 277-9877
- Emailing tandemmentalhealth@gmail.com
- Sending a message through your client portal
To submit a claim, you’ll need the superbill we’ve provided, which includes:
- Client information
- Office/provider information
- ICD-10 (diagnosis) codes
- CPT (procedure) codes
- Payment details
3. Submit Your Claim
Once your superbill is ready, submit your claim to your insurance provider. The submission method depends on your insurance’s preferences. Confirm with your provider whether they prefer claims be mailed, faxed, or submitted online using their website or client portal. Be sure to follow the specific instructions provided by your insurer to avoid delays.
These tools can simplify the process of submitting claims:
- Reimbursify
Reimbursify is an app designed to streamline filing out-of-network claims. Upload your superbill, and they’ll handle the claim submission for you.
- ClaimEye
ClaimEye allows individuals to easily submit claims for out-of-network services by uploading a superbill and other relevant documents.
4. Know Your Rights
Learn about your rights under mental health parity laws, which requires insurance companies to cover mental health services comparably to physical health care. Visit ParityTrack for more information.
5. Follow Up on Claims
If you encounter delays or denials, here’s what you can do:
- Call your insurance provider to check the status of your claim.
- If there is missing or incorrect information contact our office for assistance/updating.
- Use the appeal process outlined by your insurance company if your claim is denied.
6. Ask for Help
If you need further assistance, feel free to reach out to us. While we cannot file claims on your behalf, we’re happy to answer questions about the superbill or insurance codes we’ve provided.