Orlando Therapist: What is a Superbill for Therapy?

Written by: Lauran Hahn, LMHC

Navigating the journey to mental wellness can feel like venturing into an intricate labyrinth. You’ve spent hours searching for the right therapist and deciphering complex therapy jargon, and now you're faced with the daunting task of understanding the maze of in-network and out-of-network benefits. It's a whirlwind of emotions and confusion, and just when you think you've grasped it all, you stumble upon a new term: superbill. What is a superbill, and how does it fit into this puzzle?

As the owner of Mindful Living Counseling Orlando, I understand how overwhelming it can be to navigate through all the choice points when it comes to starting therapy.

This blog post is meant to help this process be less stressful so you can easily get the support you need and deserve. I will explain the details of using a superbill for therapy and discuss the advantages and disadvantages of this approach.

What is a Superbill for Therapy?

A superbill is a detailed invoice provided by your therapist that you can submit to your insurance company for reimbursement if your therapist does not accept insurance (also called out-of-network). It includes essential information about your therapy sessions, such as dates, services provided, and costs.

Unlike a regular receipt, a superbill contains the necessary medical coding that insurance companies require to process claims. This document bridges the gap between you and your insurance provider, potentially easing the financial burden of out-of-network therapy costs.

Why Do Many Therapists Not Accept Insurance?

Highly specialized therapists, like those at Mindful Living Counseling Orlando, invest significant time and money into becoming experts in their field. The reality is that reimbursement rates from insurance companies can be as low as $40 per session. This rate is not sustainable for therapists with advanced degrees and specialized training, who need to cover their costs and earn a living wage.

Additionally, the administrative burden associated with insurance claims, the necessity to adhere to insurance company treatment plans, and the potential compromises in client confidentiality are other factors that influence this decision. By not accepting insurance, therapists can provide more personalized, flexible, and confidential care, ultimately benefiting their clients' mental health and well-being.

How Does a Superbill Work?

A superbill serves as an essential tool for clients who receive therapy from providers outside of their insurance network. Here’s how it works:

Provision of the Superbill: After your therapy session, your therapist will provide you with a superbill. This is not a regular receipt but a detailed invoice that includes critical information about your session.

Submission to Insurance: You, as the client, will then submit the superbill to your insurance company. This step is crucial because it initiates the reimbursement process.

Insurance Processing: Once the insurance company receives your superbill, they will review it based on the details provided. The superbill includes:

CPT Codes: These are the Current Procedural Terminology codes that describe the specific services provided during your therapy session.

Diagnosis: The diagnostic code that corresponds to your mental health condition.

Dates of Service: The specific dates on which the therapy sessions occurred.

Provider Information: This includes your therapist’s National Provider Identifier (NPI) number, which is essential for processing the claim.

Reimbursement: Based on your specific insurance plan (link to ins and outs blog), the insurance company will determine the reimbursement amount. They will then issue a payment directly to you, the client. It’s important to note that the reimbursement rate and the amount covered can vary significantly depending on your insurance policy.

Disadvantages of Submitting a Superbill

While superbills can help clients get reimbursed for out-of-network therapy services, there are several disadvantages to consider. These potential downsides highlight why some therapists, including myself, choose not to accept insurance or provide superbills.

Insurance Companies Dictating Treatment

One of the most significant disadvantages of using superbills is the control insurance companies exert over your treatment. Insurance providers often have strict limits on how much they will pay per session and how frequently you can attend therapy. This means that insurance companies, rather than you or your therapist, can end up driving your treatment plan. This can limit the flexibility and personalization of your therapy, potentially hindering your progress.

Limited Confidentiality

When you submit a superbill to your insurance company, you are granting them access to certain aspects of your medical records. This access means that your therapy visits are not entirely confidential. If the insurance company requests detailed records, your therapist is obligated to provide them. This can be concerning for clients who highly value their privacy and confidentiality in therapy.

Requirement of a Diagnosis

Another significant drawback is that superbills require a diagnosis code. This means your therapist must assign you a mental health diagnosis, which may not always be in your best interest. Some clients may prefer not to have a formal diagnosis on their medical records due to potential stigma or personal reasons. Additionally, the need for a diagnosis can sometimes lead to over-diagnosing or misdiagnosing, which can impact your overall treatment and well-being.

Should I Use a Superbill for Therapy?

If your primary concern is finances and other factors are of less importance, then you should consider submitting a superbill for reimbursement. Using a superbill can help you recoup some of the costs associated with out-of-network therapy services, making mental health care more affordable.

A superbill is an essential tool that can help you navigate the financial side of therapy, particularly when dealing with out-of-network benefits. By familiarizing yourself with how superbills work and how to use them, you can streamline the insurance reimbursement process and focus more on your mental health journey. Don't hesitate to ask us for assistance with superbills!

Interested in Therapy Orlando?

We are here to assist you in finding the perfect therapist for your needs. To start with one of our therapists at Mindful Living Counseling:

1. Fill out our New Client Consultation Form.

2. Schedule a consultation call with one of our Orlando therapists.

3. Begin your healing journey!

Still Not Sure About Therapy?

Our team of highly trained anxiety therapists are ready to help you acquire the necessary tools to overcome any challenge. If you're not ready to start yet or need more information, no problem. We have excellent resources for you to enjoy in the meantime.

Anxiety Therapy Orlando Resources

Orlando Therapist Explains How EMDR Transforms Your Life by Alleviating PTSD Symptoms

5 Quick Questions to Ask [when calling about your out-of-network benefits]

Ins and Outs of Health Insurance for Counseling (In-network and Out-of-network)

Health Insurance for Therapy? You decide... Pro and Cons

Orlando Therapist: Understanding Therapy Jargon

Other Therapy Services Offered at Mindful Living Counseling Orlando

At Mindful Living Counseling we provide various therapy services for your needs. Our therapy services include Anxiety Therapy, EMDR Therapy, Trauma Therapy, Teen Therapy, and Toxic Relationship Therapy. We also offer Guided Meditations to our clients.

Orlando Therapist: Lauran Hahn

Lauran Hahn, LMHC, is an Orlando therapist who specializes in helping clients who are struggling with anxiety and trauma. In addition, she works with individuals to heal from toxic relationships. Lauran is also a Certified Sensorimotor Psychotherapist, a Certified EMDR Therapist, and an EMDRIA Approved Consultant.