Texoma Specialty Counseling & Wellness

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Unlocking Affordable Therapy: Maximizing Out-of-Network Benefits

Therapy can be a transformative and life-changing experience, but the financial burden can sometimes outweigh the benefits. This is where out-of-network benefits come into play. Many insurance plans offer out-of-network coverage for mental health services, which means that you can see a therapist who is not in your insurance network and still get reimbursed for a portion of the cost.

While it may require a bit more legwork on your part, the potential savings and benefits of using out-of-network benefits for therapy are well worth it. Using valuable resources we have options to help take out the extra legwork, and help you get your benefits back in your pocket! We have a mission to make therapy more accessible and therefore we work with verified and reputable programs to help you use your benefits to their fullest potential.

Check out https://www.thrizer.com/help/faq for an example of a program we can use to get your benefits. 


Simplified Solutions: Utilizing Thrizer for Seamless Benefit Management

Here are some steps to help you navigate the process and make therapy more affordable:

1. Check Your Insurance Plan: Review your insurance policy to see if you have out-of-network benefits for mental health services. You can usually find this information in your policy documents or by calling your insurance provider.


2. Set up your Thrizer account. If you wish to use your OON benefits we will help assist you through the very easy process to set up and add your insurance information to Thrizer. Your therapist will add a diagnosis and office visit code and after about 24-48 hours we will receive verification of your OON benefits. 


3. Pay for Sessions Upfront: If you elect to use Thrizer you will be billed the session charge through your Thrizer account. Thrizer will cover the remaining session charge. Thrizer will then submit the claim to your insurance and will only take 5% of what is owed to you! If your OON plan has a high deductible you can apply your sessions toward your deductible. You will be responsible for the full session fee and may elect to NOT use Thrizer for this service. However you will not be charged for any claims filed toward your deductible. Once you’ve met your OON deductible you will only be responsible for a portion of your session with us! At that time you only pay a “co-pay” per your OON benefits plan. Thrizer can let us know more what this exact number would look like but in most cases you can expect about 30-50% savings!!  We cannot guarantee benefits or reimbursement but Thrizer is a great ally to help us get the best use out of your medical benefits. 


4. Submit Claims for Reimbursement: After each therapy session, submit a claim to your insurance provider for reimbursement. If you wish to use Thrizer, following each session your therapist will enter session details and submit the claim through Thrizer. From there you can expect a reimbursement and we will walk you through an easy online process to assist with this. If you elect to not use Thrizer but still want to use your OON benefits you may request a Superbill from your therapist. This superbill will include all necessary documentation needed to submit to your insurance company. You will want to call your insurance to find out where to mail, fax, or email Out of Network Benefit Claims. Then once submitted you can expect a reimbursement from your insurance based on your OON benefits plan. 

5. Enjoy therapy! If you ever cannot afford your initial session fee or fee at time of service, please discuss payment options. We are flexible and would rather you attend therapy and let us help you find a way to pay for it! 


By taking these steps and utilizing out-of-network benefits for therapy, you can make mental health care more affordable and accessible. Remember, your mental health is invaluable, and investing in therapy is an investment in yourself. Don't let cost be a barrier to getting the help you need. Take advantage of out-of-network benefits and prioritize your well-being.