Navigating Out-of-Network Insurance Claims

We understand that navigating insurance can be complex, especially if your coverage is out-of-network. While Spring Health is unable to bill out-of-network insurance carriers directly, we are fully committed to providing you with the documentation you need to seek potential reimbursement from your plan.

Out-of-Network (OON) Reimbursement

If Spring Health is out-of-network for your plan, you may still be eligible for reimbursement from your insurance company depending on your specific benefits. We highly recommend calling the number on the back of your insurance card to confirm your Out-of-Network Behavioral Health benefits before you begin care.

Important Financial Disclosures

Understanding Balance Billing Risk

If Spring Health is out-of-network for your plan, you may be subject to balance billing. This means you could be held responsible for paying the full difference between Spring Health’s standard service charge and the "allowed amount" your insurance plan chooses to cover. To avoid unexpected out-of-pocket expenses, please confirm your out-of-network cost-sharing responsibilities with your insurance carrier beforehand.

Prior Authorization Requirements

Some insurance plans strictly require you to obtain a prior authorization (PA) before you receive out-of-network mental health services. Spring Health does not submit, manage, or appeal prior authorizations on behalf of members. You are entirely responsible for contacting your insurance carrier directly to request and secure any necessary authorizations before starting care.

What is a Superbill?

A Superbill is an itemized document designed specifically for insurance companies. It includes the procedure codes (CPT) and diagnosis codes (ICD-10) that your carrier needs to process a claim for potential reimbursement. 

How to Request Your Superbill

To ensure your request is handled efficiently, please have your desired date range ready (e.g., January 1st, 2025 to March 31st, 2025) and follow these steps:

1. Confirm Your Email: Confirm your email address is correct in your Account Settings.
2. Contact Our Team: Reach out to our Care Team to initiate your request.
3. Detail Your Request: In the request description, specify your request for a Superbill and the date range you need.

Once your request is processed by our Member Billing Support team, your superbill will be sent as a digital attachment directly to your email address on file.

If you don't see your superbill after our team has confirmed your request, check your spam folder for an email from our Spring Health billing team. Superbills are generated upon request; if you haven't requested one yet, please reach out to our team.