Choosing Out-of-Network or Self‑Pay Treatment: An Empowered Decision for Personalized Care
At Empowered Psychiatry, our focus is on nurturing growth, self-awareness, and resilience—not on limitations set by insurance. Opting for self-pay or out-of-network (OON) care is a deliberate choice—one that grants you more flexibility, confidentiality, and access to the tailored care you deserve.
What Does "Out-of-Network" Treatment Mean?
In-network providers have agreed upon rates and documentation processes with insurance companies.
Out-of-network providers, like us, set our own session fees and maintain autonomy from insurance constraints.
After paying session fees directly, you can submit a superbill—a detailed receipt—to your insurance for possible partial reimbursement. For instance, if you’re charged $130 and your plan allows $100 with 70% reimbursement, you’d receive $70 back, resulting in a $60 out-of-pocket cost.
Self‑Pay vs. Out‑of‑Network: What’s the Difference?
Self‑Pay:
You opt out of insurance entirely—no superbill needed.
Total privacy and no administrative steps.
Out‑of‑Network:
You pay upfront and submit a superbill for reimbursement.
Potential savings while maintaining control.
Why Choose Self‑Pay or OON Care at Empowered Psychiatry?
Your mental health journey is deeply personal and deserves individualized attention—beyond insurance limitations. Here’s why clients often choose this path:
Greater Choice & Specialization: Find a provider whose values align with yours and who specializes in what matters to you—whether that’s trauma, anxiety, holistic care, or integration of medication with treatment.
Enhanced Privacy: No forced diagnoses or detailed documentation going beyond your therapeutic relationship.
Comprehensive & Unhurried Care: We tailor session length and frequency to your needs—no artificial limits, no rushing.
Availability & Clearer Communication: Without juggling insurance-related tasks, we devote our full attention to supporting you.
These align beautifully with our mission at Empowered Psychiatry—to listen deeply, co‑create goals, model self‑care, and foster meaningful growth in a safe, supportive environment.
Questions to Ask Your Insurance Provider
If you're exploring OON care, calling your insurer with these key questions can illuminate your coverage:
Do I have out-of-network benefits for outpatient mental health and psychiatry services?
What’s my OON deductible, and how much have I met?
What reimbursement percentage or allowance applies per session?
Are specific CPT codes required (e.g., 99214 or 99213)?
Are there session limits, or is pre‑authorization needed?
What documentation is needed, and how do I submit a superbill?
Is This Approach a Fit for You?
If confidentiality, personalized pacing, and finding a provider who truly resonates with your needs matter to you, then OON or self-pay treatment could be an excellent match.
Final Thoughts
Choosing out-of-network or self-pay treatment is often about investing in quality, choice, and connection. At Empowered Psychiatry, we honor your courage to embark on a healing journey defined by authenticity and collaboration.
If you’d like to explore further or schedule a complimentary consultation, I'd be honored to walk alongside you.
