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“Do You Take My Insurance?” Let’s Talk About Out-of-Network Benefits

  • Tabitha Criner
  • Apr 2
  • 5 min read
 



We understand—you already pay a lot for your insurance, and it’s completely reasonable to think, “I should stick to in-network providers to get the most out of my plan.”


But here’s the truth: while in-network coverage may seem like the easier option, it often comes with limits. These restrictions can impact the care you receive—whether through limited therapist options, session caps, or rigid treatment policies.


The good news? Out-of-Network (OON) benefits can offer a solution—helping you access therapy without those constraints while still allowing you to use your insurance for reimbursement. It’s a middle ground that gives you greater control over your therapy experience while benefiting your wallet.


Even if you don’t know whether your insurance plan offers OON benefits, we can help. During a free consultation, we’ll verify your benefits through Thrizer, a platform designed to simplify the process. Thrizer also offers Thrizer Pay, a solution that makes OON therapy more manageable by eliminating the need to pay the full session fee upfront.



Why Clients Choose Out-of-Network Therapy


We know you might be wondering, “Why would I choose out-of-network therapy if I already have in-network coverage?” Let’s explore why many clients find OON therapy to be the best of both worlds.



 


1. You Get to Choose the Right Therapist for You


Insurance networks often limit your choices, leaving you with a small pool of providers who may not have availability or who don’t specialize in the type of care you need. Many in-network therapists are booked for months, and others may not offer services tailored to your unique concerns.

OON benefits allow you to select a therapist based on your needs and goals—not just who is on your insurance list. At White Stone Counseling Center, we offer a variety of evidence-based approaches, including 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.

Investing in a therapist who is the right fit for you is essential for long-term progress and growth.



2. Treatment Plans Are Tailored to You


Therapists who are in-network often need to follow strict insurance guidelines, which can limit how many sessions you can attend or the types of therapy that are covered. With OON therapy, your treatment plan is fully tailored to your needs. You and your therapist can work together without worrying about arbitrary limits.



3. Diagnoses Are Less of a Focus


In-network therapy typically requires your therapist to assign an official 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 focus on supporting your goals and needs without submitting detailed treatment justifications to your insurance. For clients who prefer not to have a diagnosis at all, private pay offers that option.



4. You Control the Length and Frequency of Therapy


Sometimes an hour just doesn’t cut it. In-network providers are most often limited to sessions that are one hour or less without special approval that requires jumping through hoops to acquire (or to be denied).

With OON therapy, you have full control over your session schedule. Whether you need 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 or more worth of therapy into just a few days, and sometimes even less. We have had success with reimbursement through out-of-network benefits for these kinds of sessions which would simply not be an option when utilizing in-network plans.



5. You Can Still Save Money with Reimbursement


We understand the concern: “Doesn’t going out-of-network cost more?” Many clients are surprised to learn that OON reimbursement can significantly reduce their out-of-pocket costs. Insurance plans often reimburse 50% to 80% of the session cost after you meet your deductible. In some cases, the total expense is comparable to or even less than in-network rates.

To help with this process, White Stone Counseling Center uses Thrizer to handle the logistics. Thrizer verifies your benefits, submits claims, and tracks your reimbursements for you—eliminating the hassle of managing insurance paperwork yourself.



 


Simplifying Payments with Thrizer Pay


We know paying the full session fee upfront can feel overwhelming. That’s why Thrizer Pay is here to help.


Once your OON deductible is met, Thrizer Pay allows you to only pay your co-insurance amount at each session, similar to how in-network therapy works. Thrizer pays the rest of the session fee and waits for your insurance to reimburse them—so you don’t have to cover the full cost upfront or wait weeks for your reimbursement.


With Thrizer Pay, you get the best of both worlds: financial flexibility and access to high-quality, tailored care. If you like Thrizer you aren't only limited to using it with us. Their platform can be utilized for managing all of your OON claims, opening up a world of options to best meet all of your heath care 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 help you navigate your OON benefits:

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

  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 handles the rest, making therapy more affordable and accessible.



 


Frequently Asked Questions (FAQs)


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


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


2. How much will my insurance reimburse me?


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


3. Do I need to pay upfront?


Generally, you would pay the full session cost upfront, and then receive reimbursement from your insurance company based on your plan’s specifications. However, there is an option where you do not have to pay upfront. With Thrizer Pay, you only pay your co-insurance at the time of your session plus 5% of the session fee, and Thrizer handles the remaining balance. Without Thrizer Pay, you would pay the full fee upfront, and reimbursement would come directly to you from your insurance.


4. What if I don’t have OON benefits?


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


 


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


Let us help you take the next step in your healing process.


 
 
 

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