- Do I have mental health insurance benefits?
- What is my yearly deductible, and how much is left?
- How many sessions per year does my plan cover for psychiatry vs therapy/counseling services?
- Is approval required from my primary care physician?
- Do I need “prior authorization” for psychiatric or psychotherapy services?
- What is my co-payment or co-insurance?
Note: No matter your diagnosis or progress, some health plans may limit the number sessions you can have. It is the patient’s responsibility to be aware of these limits and monitor the number of sessions remaining.
What questions should I ask my insurance before starting services with Life Psychiatry if I want to use my out-of-network insurance?
Call the number on the back of your health insurance card and ask for “member services.” Be sure to ask the following questions to verify your coverage:
- Do I have mental health insurance benefits?
- What is my yearly deductible, and how much is left?
- How many sessions per year does my plan cover for psychiatric and psychotherapy services?
- Is approval required from my primary care physician?
- Do I need “prior authorization” for psychiatric or psychotherapy services?
- How much does my insurance reimburse for out-of-network services under the following CPT codes?
- 90837 (60-minute psychotherapy session)
- 99205 (new patient psychiatric evaluation, typically 60 minutes)
- 99214 (established patient, 25-minute office visit)
- 99215 (established patient, 40-minute office visit)
- What is my co-payment or co-insurance?
- How do I submit a superbill? Is there an online portal, or do I need to mail or fax a copy?
- What is the time limit for submitting a superbill?
- What is my home and mailing address on file (to ensure payments are sent to the correct address)?
What is a superbill?
A superbill is a detailed document, similar to an invoice or receipt, that summarizes the services you received during your sessions. It is automatically generated by our electronic health system and sent to you on a monthly basis. To be eligible for reimbursement, a superbill must include the following information:
- Client’s name, address, and date of birth
- Provider’s name, phone number, and email
- Provider’s Tax ID and National Provider Identifier (NPI)
- Statement number and date issued to the client
- Diagnosis and diagnosis code
- Service type, date, and corresponding CPT code
- Fees paid for the services
This document is essential for submitting claims to your insurance company for possible partial reimbursement.
Request your Life Psychiatry superbills by emailing our billing team at billing@livefreemobile.com.
What should I consider before submitting a superbill to my insurance?
Before deciding to submit a superbill for reimbursement, here are some key points to consider:
- A diagnosis is required: Insurance reimbursement typically requires a clinical diagnosis, which will be included on your superbill. This diagnosis must align with the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or the International Classification of Diseases (ICD-10). Examples of diagnoses and their codes include:
- Adjustment Disorder with Depressed Mood (F43.21)
- Bipolar I Disorder, Current or Most Recent Episode Depressed, In Partial Remission (F31.75)
- Cannabis Use Disorder, Mild (F12.10)
- Posttraumatic Stress Disorder (F43.10)
- …and many others.
- Discuss concerns about diagnosis: If you have questions about your diagnosis or any concerns about receiving one, we encourage you to discuss these with your provider. They can provide clarification and address your concerns.
Understanding these considerations can help you make an informed decision about submitting a superbill to your insurance.
Submitting your superbill for reimbursement
Submitting a superbill can help you maximize your insurance benefits and manage out-of-pocket healthcare expenses. By understanding your coverage and following the reimbursement process, you can handle this with confidence and ease. For assistance or questions about submitting a superbill for your visit, feel free to contact Life Psychiatry.
Request your Life Psychiatry superbills by emailing our billing team at billing@livefreemobile.com.