5 reasons to accept out-of-network mental health insurance
June 23, 2022
We understand that many therapists can be reluctant to accept out-of-network insurance due to the long list of potential delays that can take place when filing claims. A few common issues include the tedious process of filling out Superbills, the inconsistency of insurance companies in accepting those bills, and disappointed clients who discover their insurance only covers a fraction of their therapy costs. Accepting out-of-network insurance presents challenges but there are many positives that come from it too. Here are 5 benefits to accepting out-of-network insurance, and how Nirvana can make it easier:
1. Say yes to more clients
On average, 3 out of every 4 clients want to seek care, however, they are unsure of their insurance coverage. You can also see this across the thousands of Google searches each month for “does insurance cover therapy.” Many therapists, especially those just starting off, need a solid base of clients to establish a self-sustaining business. One way to bring in more clients is by accepting out-of-network insurance. It will open up your client pool, and allow you to work with a wider range of people from diverse backgrounds. You shouldn’t have to turn away people who need help simply because you don't happen to be in the same network as their insurance provider.
2. Make therapy more sustainable for clients
For many people considering therapy, money can be the determining factor in whether they’ll seek out help. The cost of therapy can seem like an unnecessary financial burden, but accepting out-of-network insurance is one way to help your potential clients save money. According to our data, clients can save up to 30% of upfront costs when they are reimbursed by their out-of-network insurance. When registered with Nirvana, clients will be reimbursed for services in 90 days or less. In addition, Nirvana’s transparent payment process allows them to see the status of insurance claims online, so they can know how much they will get reimbursed and when, and be able to budget the rest of their finances.
3. No more long delays from Insurance companies
The most common issues faced by therapists accepting out-of-network insurance are the countless delays from insurance companies when filling a Superbill. One minor typo can result in months of delays. This not only adds on hours of additional paperwork for therapists, but it ultimately creates a financial burden on clients who will have to come entirely out of pocket to pay for their therapy.
Being able to reliably file Superbills to out-of-network insurance providers is instrumental to running a smooth practice where both therapists and clients are informed and comfortable. Nirvana’s Superbill filing process ensures that minor mistakes will be prevented, and that insurance companies will be responsive to claims.The reliability of Nirvana’s out-of-network claims filing makes the therapy process easier for all parties involved.
4. Simplifies the payment process
Billing for therapy sessions can get complicated when insurance companies are involved as a third party. Insurers have different rates, and clients have different levels of coverage. Keeping track of clients’ insurance can be taxing, so Nirvana has simplified this process by keeping track of the data for therapists. Now, they can track their clients' coverage rates and confidently estimate when they will start getting reimbursed for sessions. When clients approach therapists with out-of-network mental health insurance questions, they can easily refer to Nirvana's Therapist and Client portals for any of the information they’ll need.
5. Strengthens the trust between therapists and your clients
Finances can be a sensitive topic for anybody. Many people can get uncomfortable discussing what they can and cannot afford, especially when it comes to paying for mental health services. By accepting out-of-network insurance, therapists can easily work with their clients to find financial solutions to seeking therapy.
In addition, Nirvana’s billing tracker allows both client and therapists to see the costs of therapy in a clear way. Having this information easily accessible allows therapists and clients to have honest discussions about their financial relationship. In cases where a sliding scale may be necessary, clients and therapists can examine their coverage to establish a price for sessions that is affordable for all parties. This transparent process will build a new level of trust between clients and therapists who will be able to fully understand the finances of therapy.
How do I accept out-of-network insurance?
Getting added to an insurance provider’s network, or “panel,” is a long process that can take months of paperwork and verifications. Accepting out-of-network insurance requires less initial work, but the process can also be tedious. For out-of-network insurance providers, clients submit a Superbill, which contains the basic information needed for insurance companies to approve payment. It serves as a statement of a service from a provider, reflecting the date of service (DOS), the service code (CPT code), the diagnosis code, the amount the provider has billed their client for the session, and the provider’s credentials.
Submitting a Superbill to a company does not guarantee reimbursement and some insurance companies will also ask for a separate member-submitted claim form. In addition, insurance companies have separate deductibles for out-of-network and in-network services, so if a client has met their deductible for in-network benefits, but not for out-of-network benefits, they won't receive any reimbursement for their payment.
To overcome this confusion, Nirvana offers a Rate Estimation service to therapists and clients to help them estimate how much they will end up paying for therapy after maximizing their insurance coverage. In order to calculate the session costs, all they need to provide is their insurance ID number and certain demographic information like name and date of birth. Nirvana handles the rest of the process by maintaining relationships with insurance companies, and therapists and clients nationwide, to provide reliable estimations on the amount of coverage you can expect to receive from your provider.
How to get out-of-network claims paid?
The out-of-network billing process can be challenging, so Nirvana provides services to simplify this process. Once therapists onboard their practice and clients into the system, Nirvana can instantly verify benefits for all active clients and automatically file claims on their behalf. We accomplish this by being deeply integrated with the top insurance companies, and tailoring our billing engine to handle the complex rules and regulations of mental healthcare. This means clients can get reimbursed without needing to lift a finger.
When using Nirvana, therapists get paid 2x faster while saving administration hours and they’ll know whether filed claims are accepted in less than 48 hours. Billing issues are automatically tracked and addressed, and they’ll have access to a helpful support team to assist with the claims process. Our streamlined process frees therapists to work with whoever they wish to help, because they no longer need to worry about the usual hassle of dealing with out-of-network insurance companies.
Interested in knowing how much you or your clients are likely to pay for mental healthcare? Get in touch with us at firstname.lastname@example.org