Out of Network Coverage
Out-of-Network coverage is an optional feature that many major commercial insurance companies offer for members who want more options in providers. Not all plans provide Out-of-Network reimbursement, and the amount covered varies from plan to plan so it is important to know the details of your personal coverage.
If you aren't sure, you can check your insurance card to see if there is a line for "OON" services.
If your Out-of-Network coverage doesn't appear on your card, or you still aren't sure, it is best to contact your carrier by calling the customer service number on the back of your insurance card. You can also use the "Verify your Coverage" button above (works with most insurances).
For more information on how insurance works, what you pay for, and how to read an insurance card, check out this helpful resource from SAMHSA.
Filing a Claim
In order to file a claim for reimbursement you will need:
-
your insurance policy/member number found on your card and/or a photo of the front and back of your insurance card
-
the name and information of the person who received the service
-
the information of the medical provider
-
a service code or CPT code (what the visit was for)
-
an itemized bill/invoice from your doctor (provided monthly and at your request)
I am currently enrolled with Reimbursify, an app that helps clients file reimbursement claims on their own behalf. By following the links below you can both verify your coverage and file claims (works with all major private insurance companies and Tricare affiliates). **Medicaid/Medicare DO NOT offer Out of Network reimbursement.**
Once submitted, the folks at Reimbursify will fill out and file the claim on your behalf. Reimbursements are direct deposited 1-2x per month and you may upload multiple claims at a time.
* I do not receive any compensation from Reimbursify if my clients choose to use this service.
If you choose to work with your insurance company directly, you may need to mail in a claim on your own behalf. To do this you will need to download a claim form from your insurance provider. For help on how to fill out the standard claim form, click here.
Here are links to quick downloads for some of the more common companies:
Address
Telehealth and In Person at :
5267 Greenwich Rd, Ste 100 Virginia Beach, VA 23462
Phone
614-547-3135
(business cell; call or text)