Insurance reimbursement is a payment an insurer makes for eligible healthcare expenses under the terms of a member’s plan. For out-of-network therapy, the client may pay the therapist first and then submit the required documentation to request reimbursement. Whether the insurer pays, and how much, depends on out-of-network benefits, deductible status, coinsurance, the allowed amount, covered services, and claim requirements.
Reimbursement is not automatic just because a client has insurance or receives a superbill. Some plans offer limited out-of-network benefits, and some do not cover out-of-network care. Before relying on reimbursement, verify the plan’s rules and keep track of claim status, EOBs, and any submission deadlines. Read more in Deputy Care’s superbill reimbursement guide.