Out-of-Network Benefits

We provide a free “benefits checker” where you can instantly check your insurance benefits and get an estimate of your deductible, reimbursement rate, and expected out-of-pocket costs. This allows you to understand your benefits before beginning therapy.

Check your out-of-network therapy benefits here!

In most private pay practices, they just give you a super bill to submit to your insurance company, and you have to do the rest – this means you have to remember to request a super bill, download it, remember how to login into your insurance portal, upload the superbill, remember to follow up with the claim to see it’s status, etc… That’s a lot to manage! Especially given the fact that when we come to therapy we’re often coming at a time in our lives where we’re not feeling particularly at the top of our game. You’re probably just trying to make it through the day, not worrying about how to navigate the super complex world of insurance billing!

So what usually happens is those superbills just sit collecting dust in your email, and nothing ever happens with them. This is such a waste, because there is so much that can be utilized with out-of-network benefits! Instead of putting all the work on you to use your out-of-network benefits, we offer a way for you to get your claims submitted automatically so that you don’t have to worry about it. After all, your whole focus right now should be on doing the good, healing work of therapy!

It’s easy! When you schedule a session with your therapist, as part of the intake process they’ll email you a link to set up your account with Thrizer, where you can enter your insurance information and a payment method to have on file.

Once you're set up, we simply charge the payment method you provided through Thrizer after your therapy session.

If you've chosen to use your out-of-network benefits, Thrizer automatically submits your insurance claim after each appointment. That means there's no need to request or submit monthly superbills yourself (yay!). You can also track your claims and reimbursements anytime through your secure client portal.

Thrizer offers three options to work with your out of network benefits – one is completely free, and two have small service charges that are 100% optional and based on convenience to you! 

Let me breakdown the options for you:

OPTION ONE – Self-Pay (completely free)

When you set up your Thrizer account you can select self-pay, which means you want to operate like any other private pay therapy practice – you pay for your therapy session at the time of the session, and you can ask for your therapist to email you a superbill if you’d like. Then you can submit the superbill to your insurance company and wait for reimbursement checks to be mailed back to you, depending on your specific benefits and plan.

OPTION TWO– Out-of-Network Billing (1% service charge on reimbursements)

Thrizer also offers the option of submitting your out-of-network claims for you – this means you don’t have to worry about superbills and every therapy session will automatically be submitted to your insurance company for you!

If you choose this option, once your deductible is met and if you do qualify to start receiving reimbursements, then Thrizer collects a 1% service charge on that reimbursement. The 1% is based on the full fee of the session, so if your session fee is $180, then the service fee would be $1.80 per session. This service fee is not something you have to pay separetely, it’s something that’s just deducted from the reimbursement you receive back from your insurance. So for example, if your insurance reimburses for 50% of out-of-network therapy, that means you would normally get $90 back per session. If you choose the convenience of having Thrizer deal with all of the insurance submission and tracking for you, then your reimbursement received would be $88.20 (your co-insurance amount - the 1% service fee).

This option is 100% optional, and just based on convenience to you! Plus, this service charge only kicks in once you’re actually getting money back from insurance – otherwise having Thrizer submit your out-of-network claims for you to help chip away at your deductible is completely free!

This is the option that most clients choose, because let’s be honest, most of us do absolutely nothing with those superbills our therapists send us 😅

OPTION THREE– Thrizer Pay (5% service charge)

There’s a third option for using your out-of-network benefits, that you can become eligible for once your deductible has been met, and if you’ve had a few claims submitted successfully to your insurance. 

At this point, you can choose to just pay your co-insurance amount at the time of your therapy session, instead of having to pay the full fee upfront and then wait for reimbursements to come in. If this is the option you choose, there’s a 5% service fee that Thrizer collects. This 5% is based on the full fee of the session, so assuming again your full therapy session cost was $180, 5% of that would be $9. This service fee is just included in the amount you pay for your co-insurance. For example, it would mean that once your deductible has been met, if you are only responsible to pay $90 for sessions, instead of having to pay $180 and wait to get $90 back from insurance, you would just have to pay $99 (co-insurance + 5% fee) and be done with it! Again, this option is 100% optional and offered simply as a convenience to you!

Absolutely! First of all, you’re paying for health insurance so you should be able to utilize all the ways it can support you. Plus, even if you have a large deductible to meet before getting out-of-network reimbursements, submitting claims for your therapy sessions can still benefit you in the long run, because every session goes towards chipping away at that deductible. This can be really helpful if you ever encounter some unexpected out-of-network medical costs.

However, the biggest benefit of using out-of-network benefits is that you get greater choice over who to mete with for therapy. Going out-of-network allows you to choose the therapist that feels like the right fit for you, with the specialties and expertise you’re looking for (rather than having to choose a therapist simply based on whether the accept your insurance).

If you haven’t met our team of therapists yet, you can get to know them here!

No, using Thrizer to submit out-of-network claims is completely optional!

If you have out-of-network benefits, you can choose whichever reimbursement option works best for you. You may also choose to pay privately without involving your insurance at all.

Almost no work at all! All it involves from you is setting up your account, adding your insurance information, and adding a credit card (or other payment method) on file. After that, your therapist and Thrizer take care of the rest! We charge your card for sessions, submit the claims, track the claims, and then send any reimbursements directly to you if and when your plan allows for that. Of course, at any time you can also log into your portal to see the status of your claims as well.

Of course! If you’d still prefer to handle insurance claims yourself, your therapist can easily email you a monthly superbill that you can submit to your insurance company.

The easiest way to get started is to book a free 15 minute consultation with one of our therapists! They can walk you through the intake process, and answer any remaining questions you have about getting started with therapy.

Book a free consultation here!