With out-of-network services, you can still submit claims for potential of reimbursement. Potential reimbursement is the key wording as insurance companies put a lot of resources into auditing and denying claims.
Worth It PT, LLC will provide superbills / claims upon request that can be submitted to insurance. Different insurances require different steps towards submiting these claims for reimbursement. It is recommended to call the number on the back of your insurance card (titled member services) and speak to a representative about your out-of-network benefits. You may also ask them how to best submit a self-claim, and if you need pre-authorization to do so.
Follow these steps to help you with understanding the process for submitting your self claim.
Collect your superbill / itemized receipt from your provider.
Complete a claim form for your insurance provider. This claim form may be found on their website. Your insurance may require additional paperwork to be sent with the claim form. Examples of this are documentation performed by the PT detailing the session.
Make a copy of your claim for your own records.
Review your claim to ensure you have everything in order and send.
Wait. If your claim has not been processed within the calendar days promised by insurance, give them a call.
For more resources, check out these websites that give more of a detailed break-down.
About the Author:
Caroline Gamwell, DPT is a Doctor of Physical Therapy, specializing in Pelvic Floor and Women's Health. She is the founder of Worth It PT based in Denver, Colorado, a clinic whose focus is to help others achieve their health and wellness goals through a higher quality of healthcare.