Out-of-Network Benefits (OON)

Home - Insurance Reimbursement

If you are not insured by any of the insurances we are in network with, we can provide you with a superbill or support you in creating and submitting claims through Mentaya

Understanding Out-of-Network Benefits

When you use an out-of-network provider, you’re seeing a healthcare professional who does not have a contract with your insurance company. This means you will generally pay more out of pocket compared to seeing an in-network provider, who has agreed-upon rates with your insurer.

Why Choose Out-of-Network?

People often choose out-of-network providers for several reasons:

Out-of-network providers may offer longer, more frequent, or customized therapy sessions.

Patients can access therapists who have specialized expertise or unique treatment approaches that may not be available through in-network providers.

For specific conditions, such as trauma-related diagnoses, therapy in Spanish, couples therapy, or issues related to cultural challenges, grief, and loss, seeking out-of-network treatment may be necessary.

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How Reimbursement and Costs Work

While your insurance may still offer some reimbursement for out-of-network services, the specifics can vary depending on your plan. For more detailed information, it's best to contact your insurance provider directly. Some insurance plans reimburse a percentage of the costs for out-of-network appointments, so it's worth checking with your insurance provider.

For example, if an out-of-network therapist charges $150 per session and your plan covers 70% after your deductible, you'd pay the $150 upfront. Your insurance might then reimburse you $105, leaving you with a $45 out-of-pocket cost for that session.

You can check your plan by using Mentaya’s Benefit calculator below.

Receive Reimbursement: Your insurance will process the claim and pay you according to your plan’s benefits.

Your insurance will process the claim and reimburse you according to your plan’s out-of-network benefits.

We can also provide you with a “superbill” invoice that you can submit to your insurance company for reimbursement.