Exploring Out-of-Network Therapy Options: A Guide for Clients

Why Choose Out-of-Network Therapy?

We understand you already pay a lot for your insurance. It’s natural to think, “I should stick to in-network providers to get the most out of my plan.” However, in-network coverage often comes with limitations. These restrictions can affect your care, including a limited choice of therapists, session caps, and stringent treatment policies.

The good news is Out-of-Network (OON) benefits can offer a solution. They help you access therapy without those constraints while allowing you to use your insurance for reimbursement. This middle-ground option gives you greater control over your therapy experience and can be better for your wallet.

If you are unsure whether your insurance plan includes OON benefits, we can assist you. We provide a free consultation where we verify your benefits through Thrizer. This platform is designed to simplify the process significantly. Additionally, Thrizer offers Thrizer Pay, which eliminates the need to pay the full session fee upfront, making OON therapy more manageable for clients.

Why Clients Choose Out-of-Network Therapy

Many clients wonder, “Why would I choose out-of-network therapy if I already have in-network coverage?” Let’s explore the reasons many clients consider OON therapy the best of both worlds.

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1. Choose the Right Therapist for You

Insurance networks often limit your options. This leaves you with a small selection of providers who may not have availability or specialize in the type of care you need. Many in-network therapists can be booked for months. Others may not cater to your specific concerns.

With OON benefits, you can select a therapist based on your needs and goals—not just from an insurance list. At White Stone Counseling Center, we provide a range of evidence-based approaches like EMDR (Eye Movement Desensitization and Reprocessing), Ketamine-Assisted Therapy, and attachment-focused therapy. Our therapists work with clients from all backgrounds, providing personalized care designed to help you heal. Finding the right therapist is essential for your long-term growth.

2. Tailored Treatment Plans

In-network therapists often must follow strict insurance guidelines. This can limit the number of sessions you can attend or the types of therapy covered. However, with OON therapy, your treatment plan is fully individualized. You and your therapist can collaborate without arbitrary limits.

3. Less Focus on Diagnoses

In-network therapy commonly requires a formal diagnosis for insurance approval. This diagnosis becomes part of your permanent health record. In OON therapy, while a diagnosis may still be necessary for reimbursement, it doesn't drive your care. Your therapist can concentrate on supporting your goals without submitting detailed treatment justifications to your insurance. If you prefer not to have a diagnosis at all, we also offer private pay options.

4. Control Over Length and Frequency of Therapy

Sometimes, an hour just isn’t enough. In-network providers typically limit sessions to an hour or less. Getting special approval often involves navigating complicated rules, which can be frustrating.

With OON therapy, you have full control over your session schedule. Whether you require weekly, biweekly, or more intensive support, you and your therapist can decide what works best for you. White Stone offers EMDR intensives, which can condense a year’s worth of therapy into just a few days. We have successfully utilized OON benefits for these sessions, which may not be an option with in-network plans.

5. Save Money with Reimbursement

You might wonder, “Doesn’t going out-of-network cost more?” Many clients are surprised to find that OON reimbursement can significantly lower their out-of-pocket costs. Insurance plans frequently reimburse 50% to 80% of your session cost after you meet your deductible. In some cases, your total expenses may be comparable to or even less than in-network rates.

To simplify this process, White Stone Counseling Center partners with Thrizer. Thrizer handles the logistics by verifying your benefits, submitting claims, and tracking your reimbursements. This eases the burden of managing insurance paperwork.

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Simplifying Payments with Thrizer Pay

Paying the full session fee upfront can be daunting. That’s where Thrizer Pay comes in. Once your OON deductible is met, you can only pay your co-insurance amount at each session, similar to in-network therapy. Thrizer handles the rest, allowing you to avoid covering the full cost upfront or waiting weeks for reimbursement.

With Thrizer Pay, you gain financial flexibility while accessing high-quality, tailored care. Not only can you use Thrizer with us, but their platform can also manage your OON claims, providing options to meet all your healthcare needs.

How We Make the OON Process Easy

At White Stone Counseling Center, we’re committed to making therapy accessible and manageable. Here’s how we navigate your OON benefits:

1. Free Insurance Verification – We verify your benefits during a free consultation, so you know what’s covered and your estimated costs.

2. Superbill Submission – Thrizer generates and submits your superbill (a detailed therapy invoice) directly to your insurance provider.

3. Reimbursement Support – Thrizer tracks the status of your claims and manages payments.

4. Thrizer Pay – You only pay your co-insurance plus 5% of the session cost at each session. Thrizer manages the rest, making therapy both affordable and accessible.

   
   

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Frequently Asked Questions (FAQs)

1. How do I know if I have Out-of-Network benefits?

Many have OON benefits and don’t realize it. During a free consultation, we’ll verify your benefits through Thrizer, clarifying what’s covered.

2. How much will my insurance reimburse me?

Reimbursement varies by plan, but many clients receive 50% to 80% back after their deductible. Thrizer will provide an estimate based on your benefits.

3. Do I need to pay upfront?

Typically, you would pay the full session cost upfront and receive reimbursement from your insurance, according to your plan. However, with Thrizer Pay, you only pay your co-insurance at the time of your session and 5% of the session fee. Thrizer handles the remaining balance, making it more convenient.

4. What if I don’t have OON benefits?

If your plan does not include OON benefits, we can discuss private pay options and our sliding scale program during your consultation.

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Take the Next Step – Schedule Your Free Consultation

We’re here to help you understand your options, verify your insurance benefits, and make therapy more accessible. Let’s work together to create a plan that supports your healing journey.

📞 Phone: (804) 510-0936

📧 Email: admin@whitestonerva.com

🌐 Website: www.whitestonerva.com

Let us assist you in taking the next step in your healing process.