WHAT IS A PPO PLAN
PPO stands for Preferred Provider Organization. A PPO plan is a type of health insurance that lets you see any doctor or specialist you want, but you save money by using doctors in the plan’s network. You don’t need a referral to see a specialist, and you have more freedom to choose providers compared to other plans. If you go outside the network, it usually costs more.
HOW DO I CHECK IF I HAVE A PPO PLAN
Look at Your Insurance Card
Your card may say "PPO" somewhere on it—usually near the plan name or type. It might also say something like:
“BlueCross PPO”
“Aetna Open Access PPO”
“UnitedHealthcare Choice Plus (PPO)”
If it says HMO or EPO instead, it’s a different type of plan.
Check Your Insurance Portal or Plan Documents
Log into your insurance company’s website or app. Your plan type is usually listed under “Plan Details” or “Coverage Summary.”
Ask HR or Your Insurance Provider
If you have insurance through work, your HR department can confirm it for you. You can also call the member services number on the back of your card and ask, “Can you tell me if my plan is a PPO?”
How do I use my PPO plan to see an out of network therapist?
Step 1: Check Your Out-of-Network Benefits
You can utilize our complimentary insurance service to check your out-of-network benefits, or you can contact your insurance provider to ask the following questions:
“Do I have out-of-network mental health coverage?”
“What percentage do you reimburse?”
“Is there a deductible I need to meet first?”
Step 2: Ask the Therapist for a Superbill
Therapists at The Talking Corner Family Therapy Inc. are Out-Of-Network providers. Ask your therapist to give you a superbill—a special receipt with all the info your insurance needs to process a claim. The superbill can be provided on a monthly basis.
Step 3: Submit a Claim to Your Insurance
Use your insurance company’s website or app to upload the superbill and submit a claim. Some insurers let you mail it in instead.
Step 4: Get Reimbursed
If your plan covers out-of-network therapy, they’ll reimburse you a percentage after you meet your out-of-network deductible.
Contact us
admin@thetalkingcorner.com
(213)533-9224
PO BOX 114, Torrance, CA 90507