Using Your Out-of-Network Benefits at Discovery Counseling Austin
You Don't Have to Choose Between Great Therapy and Using Your Insurance
Many people think they have to pick: either use their insurance and see whoever's available, or pay out-of-pocket for the therapist they really want. But there's actually a third option that gives you the best of both worlds—using your out-of-network benefits.
What Are Out-of-Network Benefits?
Out-of-network benefits allow you to see any licensed therapist (like our clinicians at Discovery), pay them directly, and then get reimbursed by your insurance company. Think of it like going to any doctor and submitting the receipt to your insurance afterward.
Here's how it works:
- You pay your therapist directly at each session
- We provide you with detailed receipts (called "superbills")
- You submit these to your insurance for reimbursement
- Your insurance pays you back based on your specific benefits
Why Choose Out-of-Network Therapy?
You Get to Choose Your Therapist
Instead of being limited to who's in your network (and available), you can choose the therapist who's actually the right fit for you. At Discovery, we specialize in thoughtful matching—connecting you with someone who truly gets your situation, not just whoever has an opening.
Your Privacy Stays Private
With in-network therapy, your insurance company receives detailed information about your diagnosis, treatment plans, and progress. They may also conduct audits requesting copies of your therapy notes. With out-of-network, they only see basic information for reimbursement—dates of service, provider credentials, and general diagnostic codes. Your conversations, treatment plans, and personal details stay completely between you and your therapist.
No Insurance-Driven Treatment Decisions
Your therapist can focus entirely on what you need, not what your insurance will approve. Insurance companies often limit session frequency, dictate which therapeutic approaches can be used, require specific diagnoses for coverage, or set arbitrary session limits regardless of your actual progress. With out-of-network therapy, your clinician has the clinical freedom to use their expertise and training to provide exactly what serves you best—no pre-authorizations, no treatment limits, no surprise denials after you've already started therapy.
Consistent, Uninterrupted Care
If you change jobs or insurance plans, you can keep seeing the same therapist. Your therapeutic relationship doesn't get disrupted by corporate decisions outside your control.
Often More Affordable Than You Think
Many people are surprised by how much their insurance reimburses for out-of-network therapy. Depending on your plan, you might get 60-70% back, making your actual cost quite reasonable for significantly better care.
How to Check Your Out-of-Network Benefits
Before making any decisions, it's worth a quick phone call to understand exactly what your insurance offers. Here's how:
Step 1: Find Your Information
Grab your insurance card and call the Member Services number on the back. Have your card handy—they'll need your member ID.
Step 2: Ask the Right Questions
Tell them you want to understand your out-of-network mental health benefits and ask:
- Do I have out-of-network mental health coverage?
- What is my out-of-network deductible, and how much have I met this year?
- After my deductible is met, what percentage does insurance cover for out-of-network therapy?
- Is there an annual limit on out-of-network mental health benefits?
- Do I need a referral or prior authorization?
Step 3: Get the Technical Details
They might ask about service codes. Here's what to tell them:
- 90791 - Initial evaluation session
- 90837 - Individual therapy session (60 minutes)
- Provider type: Licensed therapist (out-of-network)
- Setting: Office visits and telehealth
Step 4: Do the Math
Once you know your coverage percentage, you can calculate your actual cost. For example:
Insurance covers: 65% after deductible
Your cost: $52.50 per session after reimbursement
How It Works at Discovery
Getting Started
Once you've verified your benefits and decided to move forward, we make the process simple:
- You'll pay your normal session rate at each appointment
- We'll upload detailed superbills to your client portal monthly
- You download them and submit to your insurance (most insurance companies now have mobile apps where you can simply upload photos of your superbills—no more mailing or faxing!)
- Your reimbursement comes directly to you
Ongoing Support
We know insurance can be confusing. If you run into any issues with claims or need superbills more frequently, just let your therapist know. We're here to help make this as smooth as possible.
Ready to Get Started?
The therapists at Discovery are here because we believe in doing therapy differently—with more care, more intention, and more respect for your individual needs. Using your out-of-network benefits means you don't have to compromise on getting the right fit.
Questions about out-of-network benefits? Feel free to ask during your consultation call. We're happy to help you understand your options and make the choice that works best for you.
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