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United Hands Together

OUT-OF-NETWORK BILLING

 Purpose

Beginning therapy is an important step, and we want the process to feel as clear and stress-free as possible. Below you'll find answers to the questions we hear most often — about fees, insurance, scheduling, and more. If you don't see what you're looking for, don't hesitate to reach out at info@bodhicounseling.care

Scope

Therapy sessions at Bodhi Counseling are typically 55 minutes long, though the length of your sessions is ultimately up to you. Requests to change the standard session length should be discussed with your therapist in advance so time can be scheduled accordingly.

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This policy applies to:

  • All clients whose insurance carrier is not a contracted (in-network) payer with Bodhi Counseling & Consulting Center, PC

  • All licensed clinicians and administrative billing staff at Bodhi

  • All service locations, including in-person and telehealth sessions

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Definitions

Out-of-Network Provider

A provider who does not have a contractual agreement with a client's insurance carrier. Clients may still have out-of-network benefits under their plan (typically PPO plans), which may reimburse a portion of costs after an out-of-network deductible is met.

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Superbill

A detailed itemized receipt containing all information required by an insurance company — CPT codes, ICD-10 diagnosis codes, provider NPI, dates of service, billed charges, and amount paid — that a client submits directly to their insurance carrier to request reimbursement. The client pays Bodhi in full and manages their own insurance submission.

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Courtesy Billing

A service in which Bodhi submits an insurance claim on the client's behalf as an out-of-network provider, with the Accept Assignment designation unchecked. This directs the insurance carrier to send any reimbursement directly to the client. Bodhi is paid in full by the client at the time of service and does not receive or process insurance payment.

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Accept Assignment

A designation on an insurance claim indicating whether the provider agrees to accept the insurance carrier's payment as full or partial payment. When Accept Assignment is NOT selected, the insurance carrier reimburses the client directly, not the provider.

Fee Structure

​Standard Out-of-Network Session Rate​

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Session fee (all service types)

$150.00 per session

 

Payment is due in full at the time of service. Bodhi does not reduce or adjust the session rate based on anticipated insurance reimbursement. The $150.00 rate is the client's financial responsibility in full at each session.

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Clients are responsible for understanding their own out-of-network benefits, including applicable deductibles, coinsurance, and any timely filing requirements imposed by their insurance carrier.

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A note about cost

We know $150 per session is a real number, and we don't want cost to be the thing that keeps someone from getting support.If you're navigating financial hardship, please reach out to us directly. We're willing to have an honest conversation about what might be possible. We can't promise a specific outcome, but we'd rather talk it through than have you quietly stop coming.

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Reach us at info@bodhicounseling.care or mention it to your clinician — there's no wrong way to bring it up.

Payment at Time of Service

All out-of-network clients must pay the full session fee of $150.00 at the time of service. Bodhi accepts the following payment methods:

  • Credit or debit card (Visa, Mastercard, Discover, American Express)

  • HSA/FSA cards

  • Cash or check

Bodhi does not hold or defer payment pending insurance reimbursement. Payment is required at the time of service regardless of whether a claim has been submitted or is pending.

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Failure to pay at the time of service may result in rescheduling of the appointment and/or suspension of services until the account balance is resolved.

Courtesy Billing Service

6.1  What Bodhi Will Do

Upon client request and with a valid insurance card on file, Bodhi will submit a courtesy claim to the client's insurance carrier on their behalf:

  • Client pays the full $150.00 session fee at the time of service.

  • Bodhi generates and submits a claim to the client's insurance carrier through our billing system (Sessions Health).

  • The claim is submitted without Accept Assignment, directing the carrier to reimburse the client directly.

  • If the insurance carrier approves the claim, reimbursement is sent by the carrier directly to the client. Bodhi does not receive or handle this payment.

6.2  What Bodhi Will Not Do

  • Guarantee reimbursement from any insurance carrier.

  • Adjust, reduce, or refund the session fee based on insurance reimbursement amounts.

  • Pursue appeals or disputes with insurance carriers on behalf of clients.

  • Accept or process insurance payments directly under this policy.

  • Submit claims for services rendered by unlicensed or non-credentialed staff.

6.3  Client Authorization Required

Before Bodhi submits any courtesy claim, the client must sign a Courtesy Billing Authorization form acknowledging:

  • They have paid Bodhi in full at the time of service

  • Bodhi is submitting the claim as a courtesy and does not guarantee reimbursement

  • Reimbursement, if approved, will be sent directly to the client by their insurance carrier

  • Bodhi is not responsible for claim denials, delays, or incorrect reimbursement amounts

  • The client is responsible for meeting any timely filing requirements imposed by their carrier

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7.  Superbill Option

Clients who prefer to manage their own insurance submission may request a superbill instead of courtesy billing. Superbills will be:

  • Generated through Sessions Health and delivered securely via the client portal

  • Issued within 3 business days of the session date, or upon request

  • Inclusive of all required information: provider name, NPI, license number, practice address, date of service, CPT code, ICD-10 diagnosis code, billed charge, and amount paid

 

Clients are responsible for submitting the superbill to their insurance carrier within their carrier's timely filing window. We recommend submitting promptly after receiving them.

  Important Client Notices

8.1  No Guarantee of Reimbursement

Out-of-network benefits vary widely by plan. Reimbursement is determined solely by the client's insurance carrier based on their specific plan terms, including applicable deductibles, coinsurance rates, and coverage limits. Bodhi makes no representation or guarantee regarding reimbursement amounts or approval.

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8.2  Verification of Benefits

We strongly encourage you to contact your insurance carrier before beginning services to verify your out-of-network mental health benefits, including:

  • Whether out-of-network mental health benefits are included in your plan

  • The out-of-network deductible amount and how much has been met

  • The coinsurance or reimbursement percentage after the deductible is met

  • Timely filing deadlines for out-of-network claims

  • Whether telehealth services are covered under your out-of-network benefits

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8.3  In-Network Restrictions

If your insurance plan does not include out-of-network benefits (e.g., HMO plans), no reimbursement will be available regardless of courtesy billing submission. Please verify your plan type before requesting courtesy billing.

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8.4  Timely Filing

Most insurance carriers impose timely filing limits ranging from 90 to 365 days from the date of service. Bodhi will submit courtesy claims promptly, but delays in providing insurance information may affect timely filing eligibility.

In-Network Payers

This policy applies only to insurance carriers with which Bodhi does not have a current participation agreement. Clients whose insurance carrier is in-network with Bodhi will be billed according to Bodhi's standard insurance billing procedures and contracted rates.

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Please contact our billing team to confirm whether your insurance carrier is in-network before your first appointment.

Responsabilities 

Client Responsibilities

  • Provide accurate and current insurance information at intake and notify Bodhi of any changes

  • Pay the full session fee of $150.00 at the time of service

  • Sign the Courtesy Billing Authorization prior to claim submission

  • Verify your out-of-network benefits with your insurance carrier

  • Submit superbills to your carrier within applicable timely filing windows if managing your own claims

  • Contact your insurance carrier with questions about claim status or reimbursement

  • Reach out to Bodhi directly if cost is a barrier — we're open to that conversation

Bodhi Billing Team Responsibilities

  • Collect accurate insurance information and maintain it in the client record

  • Submit courtesy claims promptly and accurately using correct CPT and ICD-10 codes

  • Generate superbills within 3 business days of request

  • Ensure Accept Assignment is NOT selected on all courtesy billing claim submissions

  • Maintain records of all submitted claims and superbills

  • Notify clients of any claim submission errors or rejections that require corrected information

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