How to use Superbills for Insurance Reimbursement for Therapy at Woven
One of the most common questions we receive at Woven Together Trauma Therapy is surrounding insurance reimbursement and our superbill process. To help make this a little clearer for you, we have put together some answers to our most-asked questions.
What is a super bill?
A super bill is essentially a fancy receipt that lists all the services you received with your therapist at Woven. It is created by our electronic health system (Sessions) and is sent to you automatically by the 4th of each month. Superbills are not to be confused with invoices. (Invoices are sent after every session and do not list diagnosis codes or your therapist’s information. You cannot submit invoices to your insurance for reimbursement, ONLY superbills.)
Every superbill will include the following information in order to be considered for reimbursement:
Your name, address, and birth date
Therapist's name, phone number, and email
Your therapist’s Tax ID and National Provider Identifier (NPI)
Statement number and date issued to you
A diagnosis and diagnosis code*
Service type, date, and code for reimbursement (CPT codes)
The fees that you paid
*Oftentimes it takes a few sessions to determine the diagnosis code. Your therapist may use a diagnosis placeholder code such as 799.9 for diagnosis deferred.
How do I use my insurance with Woven Together Trauma Therapy?
At this time, we are not able to work with insurance companies directly and are considered out-of-network. This means that we are not contracted with your insurance and reimbursement is not guaranteed unless specifically outlined in your policy. If this is the case for you, this means that you would pay us directly for therapy services and your card on file is charged after each session. We can, however, provide you with a superbill that you can submit to your insurance for potential partial reimbursement. If you are hoping to be reimbursed for your therapy sessions, you will need to call your insurance to ask about your out-of-network coverage before beginning therapy with Woven.
What questions should I ask my insurance before starting services with Woven Together Trauma Therapy if I want to use my insurance?
Call your insurance company and inquire about your out-of-network coverage. You can find your insurance’s phone number on the back of your medical insurance card. On your call ask for “member services.” Here are a few questions that you can ask to inquire about your out-of-network coverage:
Do I have out-of-network coverage for mental health services provided through telehealth?
What is my yearly deductible? Has it been met or how much more until my deductible is met?
How many sessions per year does my plan cover?
How much does my insurance plan reimburse for an out-of-network provider for CPT codes 90834, 90837, 90791, 90847, 90901?*
What is my co-payment (if applicable)?
Do I need prior authorization?
Do I need approval from my primary care provider?
What is the home and mailing address on my file? (important to ensure checks are issued to the correct address)
How do I submit a super bill? Is there an online portal or do I have to mail or fax a copy?
What is the time limit to submit a super bill?
*CPT codes refer to the type of service you received. CPT code 90834 refers to a clinical 45-minute session and CPT code 90837 refers to a clinical 60-minute session (a clinical hour is typically 53 minutes to allow time for documentation) with a modifier (02) after the code to indicate services took place over teletherapy. CPT 90791 is for our clinical assessments, and 90847 is for couples and family therapy. CPT 90901 is for a 45-minute neurofeedback session.
What are some things to consider before I decide to submit a super bill to my insurance?
Reimbursement requires a diagnosis - a superbill, just like any other paperwork submitted to insurance for reimbursement, requires a clinical diagnosis as classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) and the International Classification of Diseases (ICD-10). Examples of diagnoses and their codes can include:
Obsessive-compulsive disorder, unspecified (F42.9)
Posttraumatic stress disorder (F43.10)
Anxiety disorder (F41.9 )
And many more...
If you have ongoing questions about your diagnosis or feel uncertain about receiving one, your therapist is here to support you through this process, so don't hesitate to share your concerns with them.
Insurance typically requires a diagnosis to demonstrate the "medical necessity" of therapy, rather than solely addressing issues like grief or relationship challenges. This is why couples therapy may not be reimbursed by insurance providers. To explore your coverage options, consider having a conversation with both your therapist and your insurance provider. They can provide more information tailored to your specific situation.
How do I submit my super bill?
Insurance companies often have specific timeframes for submitting a superbill, which can range from 90 to 180 days, falling under what's referred to as "timely filing." To initiate this, you can contact your insurance company's "member services" or refer to their website for detailed instructions.
Mail - If you choose to mail the super bill, make sure to factor in delivery time to stay within the filing deadline.
Fax - For privacy considerations, if you're faxing, it's we don’t recommend using a public or work fax machine, as the receipt may contain sensitive health information.
Online portal - The online portal option tends to be the most secure and efficient superbill submission method. It usually involves a login or password requirement, which helps protect your information. It's also quicker than traditional mail or fax. If you're unsure about this option, don't hesitate to reach out to your insurance provider for guidance.
What can you expect after you submit a super bill?
Insurance companies typically have a specific timeframe for submission. Remember, if you submit after this timeframe, you might risk missing out on potential reimbursement. The processing time for your super bill with your health insurance usually takes about 2 to 4 weeks. They might cover the full-service amount after deducting your copay, or they might apply it to your deductible. If your super bill gets denied, don't worry. Reach out to your insurance provider and ask for information about the denial. This will help you understand the situation better and explore possible next steps.
Interested in starting therapy with one of our wonderfully warm trauma therapists? You can book a therapist matchmaking appointment with our therapist matchmaker. Matchmaking appointments take about 30 minutes and you will discuss your schedule, things you are wanting to address in therapy, fees, and answer any questions that pop up.