Out of Network Provider - Frequently Asked Questions

Do you accept my insurance?

Empowered Heart Integrative Mental Health Care is considered an out-of-network provider, which means we don't work directly with insurance companies to bill them for your visits. Instead, you pay us for your services upfront. However, we can give you a superbill after your appointment.

What is a superbill?

A superbill is a detailed receipt that we send you through the Tebra patient portal after your visit. It includes information about the services you received, the diagnoses made, and the costs. This document helps you submit claims to your insurance company for reimbursement.

How do I submit a superbill?

1. After your appointment, we’ll provide you with a superbill that lists the services you received.

2. Look at your insurance policy to see if there are specific forms or guidelines for submitting claims.

3. If your insurance requires it, fill out their claim form. You can usually find this on their website.

4. Include the superbill with your claim form. This shows what services you received and their costs.

5. Send your completed claim form and superbill to your insurance company. This can often be done online, by mail, or through their app.

6. After submitting, check with your insurance company to confirm they received your claim and find out when you might receive reimbursement.

We also love the tool Reimbursify, which helps you to submit your superbills to your insurance company. Please note, we are not affiliated with Reimbursify, and Reimbursify will charge you $3.99 per claim.

How much money will I get back from my insurance company?

The amount of money you get back from your insurance company when you submit a superbill depends on several factors:

• Insurance Plan Coverage: Check your insurance policy to understand how much they reimburse for out-of-network services. Some plans cover a percentage of the cost, while others may have a set reimbursement amount.

• Deductible: If you haven’t met your deductible yet, you may need to pay a certain amount out of pocket before your insurance starts reimbursing you.

• Co-payment: Even after meeting your deductible, you might still have to pay a portion of the cost for each visit.

• Out-of-Network Limits: Some insurance plans have limits on how much they will reimburse for out-of-network services. Make sure to check if there’s a maximum amount they will cover.

To get a clearer idea of how much you might get back, it’s best to review your insurance policy details or contact your insurance company directly. They can provide specific information based on your plan and your visit to Empowered Heart Integrative Mental Health Care.

The following information may help you when speaking with your insurance company:

We use the CPT code 90792 for initial appointments. As of July 2024, in the Nashville area, the typical “allowable” rate for an out-of-network provider such as Empowered Heart is $363* (www.fairhealthconsumer.org)

*This is not a guarantee of your individual plan’s allowable, and you should contact your individual insurance provider to verify your out of network benefits.