đź’ˇ Using Your Out-of-Network Benefits May Be Easier Than You Think- Concierge Billing
Using your out-of-network PPO benefits shouldn’t feel overwhelming. That’s why Pacific MFT Network provides complimentary concierge billing support to make the process easier and more convenient.
Using out-of-network benefits gives you the freedom to choose the therapist who best meets your needs, rather than limiting you to your insurance company’s provider network. Your privacy remains important to us. We share only the information required to process your claims, in accordance with applicable laws and insurance requirements.
How Our Concierge Billing Service Works
We review your benefits. Before you begin therapy, we provide a complimentary verification of your insurance benefits. This can help you better understand your deductible, potential reimbursement, and estimated out-of-pocket costs.
You pay at the time of service. Once therapy begins, you pay the full session fee at the time of each appointment.
We submit your claims. After each session, we electronically submit the insurance claim directly on your behalf.
We monitor your claims. We follow up to confirm that your claim was received and processed by your insurance company.
We help address problems. If a claim is denied, delayed, or processed incorrectly, we contact the insurance company and help resolve the issue whenever possible.
We explain the insurance language. We can help you understand your Explanation of Benefits (EOB) and Verification of Benefits (VOB) so the information feels less confusing.
No Superbills to Manage
A superbill is an itemized document that includes information such as your dates of service, session fees, diagnosis code, and procedure code. Insurance companies use this information to evaluate claims for possible reimbursement.
Many out-of-network clinicians provide clients with monthly superbills that clients must submit themselves. This can delay reimbursement, especially when forms are difficult to understand or claims are submitted incorrectly. Some clients have told us that they previously accumulated months of unsubmitted claims because the process felt so confusing and time-consuming.
With Pacific MFT Network, you don’t have to manage superbills or submit claims on your own. We electronically file claims after each session and follow up when needed. If your plan provides out-of-network reimbursement, payment is generally sent directly to you.
Understanding Your Coverage
We recommend contacting your insurance company’s customer service department to confirm your out-of-network mental health benefits. However, representatives may have limited access to plan details, and the information provided by an insurance company is not always a guarantee of payment.
Coverage, reimbursement amounts, deductibles, claim-processing times, and final benefit determinations are controlled solely by your individual PPO plan. Pacific MFT Network cannot guarantee reimbursement. To clarify, we are not in-network or paneled with any insurance companies.
Contact us for a complimentary benefits review before scheduling your first appointment. https://www.pacificmft.com/therapist-info/meet-our-team
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