> ## Documentation Index
> Fetch the complete documentation index at: https://docs.guzmanbaker.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Out of Network Insurance

If we are not in-network with your specific insurance plan, you still have options to get your care covered. Here is exactly how out-of-network billing works and how you can use a "superbill" to get reimbursed.

## What is a Superbill?

A superbill is simply a detailed, itemized medical receipt. When you pay out-of-pocket for a medical or psychiatric appointment, standard credit card receipts do not contain the clinical information that insurance companies require to process a claim.

A superbill bridges that gap. It contains all the exact coding your insurance company needs to verify the service and process your reimbursement.

| **Information Type** | **What it includes**                                                                                                    |
| :------------------- | :---------------------------------------------------------------------------------------------------------------------- |
| **Provider Details** | Our practice name, provider NPI (National Provider Identifier), tax ID, and state license details.                      |
| **Patient Details**  | Your full legal name, date of birth, and home address.                                                                  |
| **Visit Details**    | The date of service, the amount you paid, and the specific place of service code (showing it was a telehealth session). |
| **Medical Codes**    | The standardized CPT (procedure) codes for psychiatric care and the ICD-10 (diagnosis) codes from your session.         |

## The Out-of-Network Claim Process

Submitting a superbill is straightforward, but it requires you to act as the intermediary between our practice and your insurance company.

<Steps>
  <Step title="Verify Your Out-of-Network Benefits">
    *Before your first session.*

    Call the member services number on the back of your insurance card. Ask specifically if your plan includes out-of-network coverage for outpatient mental health telehealth services, and verify if you have an out-of-network deductible to meet before they start reimbursing you.
  </Step>

  <Step title="Pay for Your Session">
    *Time of service.*

    Because we are out-of-network with your plan, you are responsible for paying the full self-pay rate at the time of your appointment.

    Please review our [Financial Responsibility & Payment Policy](/policies/financial-responsibillity-payment-policy) for for details.

    <Note>
      **Important Note:** For all self-pay appointments, payment will automatically be processed at the close of the business the day of your appointment.
    </Note>
  </Step>

  <Step title="Download Your Superbill">
    *After your provider finalizes notes.*

    We will generate your superbill. You can securely download this PDF directly from your [Jane patient portal](https://app.mintlify.com/guzmanbakerbehavioralhealthservices/guzmanbakerbehavioralhealthservices/editor/main/~/3dd2ddf6-b0a4-4bfa-b293-768e344b2a76)— no need to wait for the mail.
  </Step>

  <Step title="Submit the Claim">
    *Before your plan's filing deadline.*

    Log in to your insurance company's online member portal or mobile app and navigate to the "Submit a Claim" section. Upload the superbill PDF. Most major insurers allow for quick digital uploads, though a few may still require you to mail or fax the document.

    <Info>
      **A quick tip on timing**: Insurance companies have strict "timely filing" deadlines for out-of-network claims. Some require you to submit the superbill within 90 days of your appointment, while others give you up to a year. We recommend downloading and submitting your superbills at the end of each month so you don't miss the window.
    </Info>
  </Step>

  <Step title="Receive Your Reimbursement">
    *Usually 2 to 6 weeks.*

    Your insurance company will process the claim based on your policy's allowed amounts. If approved, they will send the reimbursement directly to you via check or direct deposit.
  </Step>
</Steps>