Out-of-Network Therapy Options | JL Family Services
JL Family Services Ltd
Understanding Your Insurance Options

Your therapist may still be an option, even when we are out of network.

We reviewed the insurance information you provided and, at this time, JL Family Services is not an accepting in-network provider with your insurance carrier. That does not automatically mean you have to give up the therapist or care you were hoping to receive.

What does “out of network” mean?
It means JL Family Services does not currently have a contracted in-network agreement with your specific insurance plan. If you choose to continue care with us, you may be responsible for the self-pay cost unless your plan provides out-of-network benefits, approves another arrangement, or you qualify for a reduced self-pay rate through our practice.

Before you decide, advocate for the care you want.

Insurance networks can be confusing, and coverage can vary even among plans from the same insurance company. We encourage you to confirm your benefits directly with your plan and ask what options are available to you.

1

Confirm our network status with Member Services

Call the Member Services number on the back of your insurance card and ask them to confirm whether JL Family Services, your matched therapist, or the provider associated with your services is in network under your exact plan.

Need an NPI for the search? Reply to the email that brought you to this page and our billing team can provide the provider NPI that may help Member Services complete the search.

2

Ask about out-of-network benefits

Some plans will reimburse a portion of therapy services received from an out-of-network provider. Ask about your out-of-network deductible, coinsurance, reimbursement percentage, allowed amount, and whether your plan accepts superbills.

Also ask whether you must meet a separate out-of-network deductible before reimbursement begins.

3

Ask about a single case agreement or network exception

You may ask your insurance company whether a single case agreement, network gap exception, continuity-of-care arrangement, or other special authorization may be available.

These arrangements are determined by the insurance company and are not guaranteed, but they may be worth asking about when you have identified a therapist who is a strong clinical fit or when appropriate in-network options are limited.

4

Talk with your HR or Benefits Department

If your insurance is provided through your employer, contact HR or your Benefits Department and explain that you would like to receive care from JL Family Services. They may be able to contact the employer’s benefits broker or insurance representative to ask about available options.

JL Family Services NPI information you may provide:
1346556966 1194189712
5

Ask what documentation is required for reimbursement

If your plan has out-of-network benefits, ask exactly what they require you to submit. This may include a superbill, diagnosis code, procedure code, provider information, proof of payment, or a specific claim form.

6

Consider self-pay or a reduced self-pay rate

If you want to continue with the therapist you were matched with, you may choose to pay our self-pay rate. A reduced self-pay rate may also be available when approved by the practice.

Our billing team can explain current self-pay options before you make a decision.

Questions to ask when you call your insurance company

You do not need to know insurance terminology before you call. You can simply tell Member Services that you have identified a therapist you would like to work with and want to understand every coverage option available under your plan.

You can ask:

  • Is JL Family Services in network under my specific plan?
  • Can you search using the provider’s NPI?
  • Do I have out-of-network mental health or behavioral health benefits?
  • What is my out-of-network deductible, and how much have I met?
  • After the deductible, what percentage of an out-of-network therapy session may be reimbursed?
  • What is the plan’s allowed amount for outpatient psychotherapy?
  • Can I submit a superbill for reimbursement?
  • Is a single case agreement, network gap exception, or continuity-of-care option available?
  • If I want to request an exception, what form or documentation is required?
  • Do I need prior authorization before starting or continuing services?
Helpful tip: Write down the date of your call, the representative’s name, and any reference or call number they provide. If you are given information that differs from what our office received during verification, send that information back to our billing team so we can review it with you.

Your insurance benefits are one part of the decision — not the whole decision.

Finding a therapist who feels like the right clinical and personal fit matters. If the therapist you selected is out of network, you are allowed to ask questions, request more information, and explore whether your plan offers another path to coverage. Our goal is to give you accurate information so you can make an informed decision about your care.

Please keep in mind: Verification of benefits is not a guarantee of payment or coverage. Insurance approval, reimbursement, network determinations, exceptions, deductibles, and claim decisions are made by your insurance plan. JL Family Services cannot guarantee that an insurance company will approve a single case agreement, network exception, reimbursement request, or other benefit.

If you received this page by email, you may also simply reply directly to that email and ask us for the provider NPI to use when contacting Member Services.

JL Family Services Ltd

Questions about insurance, network status, or payment options? Contact our Billing Team at billing@jlfamilyservices.com.

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