Insurance Options
At Heron & Lily Psychiatric Services, we want to make mental health services accessible, even if we don’t directly take insurance. We operate as an out-of-network provider, which means we do not bill insurance companies ourselves.
#1 Using a Superbill
#2 PPO Insurance Plan
Basically, we won’t send a bill to your insurance, but we will work with you by providing the documentation you need, and if you have a PPO plan you can submit that paperwork to your insurer for some financial support on the costs.
What Is a Superbill?
A “Superbill” is essentially a detailed invoice or receipt for the mental health services you’ve received. This is a special document we can give you after your session that lists important information like the dates of your visits, the services provided, and the fees. In other words, it shows an itemized list of the services you received from an out-of-network provider. Insurance companies require this information to process any reimbursement.
So how does a Superbill help you? If a mental health services provider is out-of-network and doesn’t bill your insurance directly, you can pay for the session and then ask your insurance to pay you back for part of the cost. A Superbill is the paperwork that lets you do this. You submit the Superbill to your insurance company (often through an online patient portal or by mail), and your insurer will treat it like a claim for reimbursement. If your health plan offers out-of-network benefits, the insurance company will review the Superbill and then send you a reimbursement check or direct deposit for a portion of the session fee.
HOW IT WORKS
Clients pay Heron & Lily Psychiatric Services directly at the time of service.
A Superbill is provided to the client after the appointment.
The client submits the Superbill to their insurance provider for reimbursement.
If eligible, the insurance company reimburses a portion of the cost directly to the client.
What Is a PPO Insurance Plan?
A PPO (Preferred Provider Organization) is a type of insurance plan that gives you flexibility to see both in-network and out-of-network providers. If you have a PPO plan, you are typically allowed to receive services from providers outside your insurance network and still receive partial reimbursement.
When you see an out-of-network provider like Heron & Lily Psychiatric Services, you pay for services directly, but then have the option to file a claim with your PPO plan using a Superbill. After processing, the insurance company may reimburse you a portion of the cost based on your plan’s out-of-network coverage terms.
Each plan is different, so we encourage clients to check with their insurance provider to understand their specific reimbursement rates and deductible requirements for out-of-network psychiatric services.
Why This Matters
While Heron & Lily Psychiatric Services does not submit insurance claims or accept insurance directly, many clients successfully use a Superbill in combination with a PPO plan to reduce their total cost of care. These options allow clients to receive personalized mental health services without being limited by in-network provider lists.
If you’re interested in working with Heron & Lily Psychiatric Services and would like to explore using your insurance benefits, we’re happy to assist. We can explain how Superbills work, guide you on how to submit claims to your PPO plan, and help clarify what to ask your insurance provider.