Therapure
Guides
Superbills and Out-of-Network Benefits
I am private pay and do not bill insurance directly. I can provide superbills for clients who want to ask their plan about out-of-network reimbursement. It helps to check the details before assuming that a session will be covered.
What is a superbill?
A superbill generally includes provider details, service dates, procedure codes, fees, and diagnostic information when required. Your plan uses that information to review a claim according to its benefits and rules.
It differs from a simple payment receipt. Before requesting one, ask what information your plan needs and consider the privacy implications of sending clinical information to an insurer.
Does out-of-network coverage mean I will be reimbursed?
Not necessarily. Some plans have out-of-network mental health benefits, often through PPO coverage, while others may offer no benefit for this care. Having the benefit does not mean every submitted service qualifies.
An out-of-network deductible may need to be met first. Reimbursement may be calculated from the plan's allowed amount, not the full fee you paid. Ask how those rules apply to your current plan.
What questions should I ask my plan?
Ask whether outpatient mental health services with an out-of-network LMFT are eligible. Check the deductible, how much remains, the reimbursement percentage, and the allowed amount for the service you expect to receive.
Also ask about medical necessity, diagnosis requirements, authorization, telehealth coverage, and whether couples services qualify. Individual and couples sessions should not be assumed to have the same coverage rules.
How do I submit a superbill?
Your insurer can explain its claim form, submission method, required attachments, and filing deadline. Ask whether it needs proof of payment or additional provider information, and keep copies of what you send.
If a claim is denied or unclear, contact the plan for its explanation and review options. I can discuss documentation questions, but I cannot decide coverage or guarantee the insurer's response.
How does payment work at Therapure?
You pay the practice directly rather than having us submit a claim on your behalf. The Rates page lists current fees for individual and couples services. Any approved reimbursement is handled according to your plan.
I set aside 45 minutes for individual work and 60 minutes for couples appointments. I see clients in Manhattan Beach and by video in California, Arizona, and Missouri. You can use a free consultation to ask about the practice before deciding whether to begin; insurance questions belong with your plan.
What Else Might You Want to Know?
Can I use a superbill without out-of-network benefits?
Will a diagnosis be shared?
Can you tell me the amount I will receive?
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