What are Out-Of-Network (OON) benefits?
Art therapy and counseling are more accessible than ever using your out-of-network benefits.
I want to see a therapist but the one I want to see doesn’t accept my insurance.
As with all things in life, you have options. If you want to see an out-of-network therapist, you will need to pay the therapist’s full session fee up front. You have the option to use your out-of-network insurance benefits to get reimbursed directly. You also have the option to avoid using your insurance entirely.
I can’t afford to self-pay for therapy.
It’s understandable that if a therapist markets themself as out-of-network then one may assume, after paying the full session fee, the therapist will not be involved with insurance in any capacity and that’s that.
The reality is less black and white. You have the option to self-pay without filing a claim to insurance, which provides the utmost privacy to you and your treatment. You also have the option to use your out-of-network benefits which involves self-paying for services upfront, filing a claim to insurance, and getting reimbursed by insurance later.
How do Out-Of-Network benefits work?
To use out-of-network benefits, you pay the full session fee to the therapist and then your insurance will reimburse you, the insurance member, directly.
In order for insurance to pay you, they need proof that you received treatment. This can be done via:
Submitting a superbill, AKA a fancy receipt, provided by the therapist for you to directly submit a claim to your insurance.
Courtesy billing, or when the therapist files the claim to insurance for you so you don’t have to worry about it.
Outsourcing the out-of-network billing entirely to Mentaya, and Mentaya will bill the insurance for you so you don’t have to worry about it. Sure Mentaya will charge a small convenience fee to do so, but the benefits (convenience, lack of paperwork, timesaver, dealing with possible claim denials, etc) greatly outweigh the cost.
You mean I can actually see any therapist I want?
That’s right You have full autonomy and control in choosing your therapist. An in-network therapist is not necessarily “better” than an out-of-network therapist and vice versa. Also a therapist who is out-of-network is not necessarily less accessible than a therapist who is in network.
To put it in perspective, in-network therapists frequently have full and overloaded schedules due to the demands of the work environment to compensate for the low payments from insurance. Because of this, in-network therapists are more likely to be burned out and consequently provide less effective therapy than out of network therapists. Sure an in-network therapist is more affordable but this could be at the expense of accessing the therapist’s compassion and empathy, which are needed to form trust and safety in the therapeutic relationship.
Out-of-network therapists in general see less patients because they get paid more, which in effect allows out of network therapists to have the energy and stamina to consistently show up for their patients and provide the most effective care.
What a relief!
What insurances do you accept?
Providers at Coastal Art Therapy Services currently accept:
Sentara Health Plans (commercial and medicaid)
TRICARE (certified out of network)
We will update this section as we get added to more insurance panels. For all other insurances we are out-of-network.
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Easily check your OON benefits now!
As an out-of-network provider, I have partnered with Mentaya to help my patients save money on therapy. Use this tool below to see if you qualify for reimbursement for my services.
