International Considerations: Billing and insurance processes vary by country and region. This process applies to U.S.-based members only. If you are located outside the U.S., please contact your Care Navigator for next steps.
We are committed to supporting your care journey, even after your sponsored sessions have been used. If Spring Health is out-of-network with your insurance provider, you can still continue working with your provider on a self-pay basis. While we cannot bill out-of-network carriers directly, we will provide you with the necessary documentation to seek reimbursement through your plan.
Why can't Spring Health bill my out-of-network insurance directly?
Spring Health does not have a direct contract with out-of-network insurance providers. Because there is no pre-established agreement, we cannot submit claims on your behalf. Instead, we transition your account to a self-pay model, where you pay for the session upfront.
Seeking Reimbursement (Superbills)
Many insurance plans offer out-of-network benefits that allow you to get back a portion of what you paid. After your visit, you can request a Superbill—a detailed, itemized receipt with the clinical codes your insurance requires. You can submit this Superbill directly to your insurance carrier to request reimbursement.
We highly recommend calling the number on the back of your insurance card to ask about your Out-of-Network Behavioral Health reimbursement rate so you know exactly what to expect.
Understanding Session Costs
If you move to a self-pay model, your session costs may vary based on:
- The length of the appointment.
- The type of treatment (e.g., therapy vs. medication management).
- The specific pricing established by your Benefit Sponsor.
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.
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