Filing for Out-of-Network Insurance Reimbursement

💡 How to File for Reimbursement with Your Insurance Company

While Thriving Rivers is currently private pay only while working to become credentialed under different insurance companies, many of our clients can successfully obtain out-of-network reimbursement through their insurance plans. We’ve created this guide to help you advocate for those benefits confidently and efficiently.

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✅ Step 1: Contact Your Insurance Company

Call the number on the back of your insurance card and ask the following questions:

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• “I am planning to receive services from an out-of-network provider. What are my out-of-network benefits for psychological services?”

• “What is my out-of-network deductible, and how much of it has been met?”

• “What percentage of the cost will be reimbursed after I meet the deductible?”

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Common CPT Codes:

• Psychological Assessment: 90791 (intake), 96136, 96137, 96130, 96131

• Individual Therapy: 90791 (intake), 90832, 90834, 90837

• Group Therapy: 90853

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✅ Step 2: Ask About Preauthorization

Some insurance plans require preauthorization for reimbursement.

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Ask:

• “Do I need preauthorization for these services?”

• If yes, request:

  • Authorization number

  • Number of approved sessions (for therapy)

  • Expiration date of authorization

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Note: Preauthorization requirements are becoming less common but still vary by plan.

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✅ Step 3: Submit a Superbill After Payment

Once your services are rendered and paid in full, we can provide you with a Superbill upon request. This document includes all necessary information for insurance submission, such as:

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• Date(s) of service

• CPT (billing) codes

• Diagnosis codes (ICD-10/DSM-5-TR)

• Provider NPI and business information

• Total amount paid

• Service location

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📧 To request a Superbill, email us at thrivingriversllc@gmail.com. Please allow up to 5 business days for processing. Superbills are only available for fully paid accounts.

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⚠️ Please Note

• Reimbursement is not guaranteed and is subject to your individual insurance plan’s policies.

• Thriving Rivers cannot communicate with insurance companies on your behalf or be held responsible for denied claims.

• All services are private pay only until we complete the insurance credentialing process.

We're here to support you and your child with expert, compassionate care—and we’re happy to help you navigate this process to the best of our ability.

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Warm regards,

Dr. Bryan Wilson
Thriving Rivers School Psychological and Educational Services

📍 200 Putnam Street, Suite 410, Marietta, OH 45750
📞 740-401-9766 | 📧 📞 740-401-9766 | 📧 thrivingriversllc@gmail.com | 🌐 thrivingrivers.com