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Faith-Based Therapy: How to Get Insurance to Cover Out-of-Network Therapists

Lisa Sojourner - M.A., LMHC

Free Downloadable Worksheet!

Click here for a downloadable PDF worksheet that will help you brainstorm and gather all the information we cover in this article!

In my over a decade experience as a therapist, one of the biggest obstacles to seeking help often isn't stigma for mental health, finding a therapist you trust, or scheduling, it's finding a way for insurance to cover the cost.

Why are therapists leaving insurance companies and going out-of-network?

More and more therapists are moving away from taking insurance, limiting the number of options you have as a client. Therapists are moving due to ethical concerns. Many feel that insurance companies prioritize profit over patient care:

  • Limiting the number of sessions

  • Restricting types of treatment

  • Determining treatment modalities

  • Denial of coverage

  • Claw backs: denying coverage after care has been given and requiring both therapist and client to reimburse the insurance company. These concerns hinder therapists' ability to provide quality care tailored to their clients' needs. By transitioning to self-pay, therapists prioritize their clients' well-being without being constrained by insurance company policies.

What do you do when you find a therapist you love who is out-of-network?

So you've found someone who fits all of your needs, but they don't take your insurance? There is hope that you can get sessions covered with the right approach and documentation. I have seen many clients successfully navigate the process and receive reimbursement for their sessions! Below are some steps you can take to see if you can get your sessions covered!

Before You Contact Your Insurance Company:

  1. Define why you NEED out of network: Insurance companies are going to want to know why you need out-of-network when there is a long list of therapists available. You need to be ready to explain what an out-of-network therapist will provide, including it's medical necessity, that one of their in-network therapists can't. Below are some potential reasons to help you brain storm.:

  • Cultural or religious alignment: Individuals may seek out-of-network therapists who share their cultural background or religious beliefs to ensure a more culturally sensitive and understanding therapeutic relationship. Explain to your insurance company that you cannot find a in-network therapist that aligns with your particular cultural needs.

  • Specialized Expertise: Sometimes, individuals require a therapist with specific expertise or training that is not readily available within their insurance network. Examples of why you would need to see a Christian therapist for this expertise include: religious trauma, scrupulosity, spiritual integration, etc.

  • Therapeutic approach: Some people may benefit from a therapeutic approach or modality that is not commonly offered by in-network therapists. Examples of this include EMDR, IFS, CBT, ERPT, etc. When speaking with the therapist, ask them if they have any specific therapeutic approaches you could include in your list to your insurance company.

  1. Get a Referral: If possible, obtain a referral from your primary care physician or a health care professional in your network. This can strengthen your case for out-of-network coverage.

  2. Seek Documentation: Ask your out-of-network therapist for documentation that highlights their specialization in working with people of your religion. This could include their qualifications, training, or any specific approaches they use that align with your religious beliefs.

During the Call to Your Insurance Company:

  1. Understand Your Coverage: The best way to understand your coverage is to call the number on the back of your insurance card. Call your insurance company and explain your situation. Explain that you NEED a therapist with specialization in your religion and that there are no therapists in-network who meet this criteria in your area. Ask about the process for out-of-network coverage and what information they need from you or your therapist.

  2. Ask for the Process: Private pay therapists do not submit claims for you. While you are speaking to your insurance rep, make sure to ask them what the process is for submitting for reimbursement. Sometimes they will need the therapist to submit paperwork, or you will need to get specific information from the therapist such as their NPI number, etc. There will also be a process for sending in information such as superbills. Make sure to document this process so you have everything you need and to ensure there are not delays in claims processing.

After the Call

  1. Request a Superbill from Your Therapist:  If insurance will cover your sessions, you will need to request what is called a superbill from your therapist. This is basically a receipt of your session that includes things like a diagnosis and CPT code that insurance will use to determine amount you will be reimbursed. Once you have this receipt you submit this to your insurance company in order to be reimbursed.

  2. Appeal if Necessary: If your request is denied, don't lose hope. You have the right to appeal. Contact your insurance company for guidance on the appeals process and provide any additional information or documentation that supports your case.

  3. Stay Persistent: Dealing with insurance can be frustrating, but don't give up. Keep records of all communication and follow up regularly to ensure your request is being processed.

Seeking therapy that aligns with your religious beliefs can be an important aspect of your mental health journey. By understanding your insurance coverage and advocating for your needs, you can increase the likelihood of getting approval to see an out-of-network therapist who meets your specific requirements.


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