Insurance and superbills

Iron Ridge is out-of-network. We can bill your PPO out of network, give you a superbill, or you can pay privately with no claim. What to ask your insurer first.

A superbill is an itemized receipt containing the clinical codes your insurance carrier needs to process an out-of-network claim. Iron Ridge provides one, and you submit it yourself. If you would rather not handle the claim, we can bill your PPO out of network for you. And if you want nothing on an insurance record at all, you can pay privately and we never contact your insurance company.

Three ways to pay

Out-of-network billing. You pay up to your plan's out-of-network out-of-pocket maximum, and we bill your PPO out of network through a third-party billing service that works under a HIPAA business associate agreement. The claim carries a primary mental health diagnosis based on your intake assessment. Before you start, we check your out-of-network benefits so you know what your plan covers.
Superbill. You pay Iron Ridge directly, we provide a properly coded superbill, and you submit it to your carrier yourself.
Private pay, no claim. You pay Iron Ridge directly and nothing goes to an insurer. We submit no claim, seek no prior authorization, and do not report your diagnosis, your attendance, or your progress to any insurer.

We are not in network with any carrier. The private-pay option is there by design, not by default. It is explained in full on our pricing page and in accreditation and licensure.

Why this matters more here than elsewhere

Using insurance means a diagnosis enters your permanent claims record, held by your carrier and accessible through the channels that record is accessible through. For most conditions that trade is worth making without a second thought.

For a man whose central concern is that this stay off a record his employer, his spouse, or his licensing board could reach, it is a different calculation entirely. Private pay with no claim removes the carrier from the transaction. There is no claim, no authorization request, and no diagnosis transmitted anywhere.

This is a structural protection, not a policy promise. We are describing how our billing works. We are not making guarantees about what any third party may be able to obtain through other means.

How the superbill process works

You pay Iron Ridge directly.
We provide a superbill covering the services delivered.
You submit it to your carrier under your out-of-network benefits, usually through their member portal or a claims address on your card.
Your carrier makes a determination.
If they reimburse, they pay you directly. Nothing routes back through us.

What to ask your carrier before you start

We can do this for you. Send us your insurance card and we will check your out-of-network benefits and call you with what we find. If you would rather ask yourself, call the member services number on your card and ask these four questions. The answers determine whether using your out-of-network benefits, through billing or a superbill, is worth it.

Do I have out-of-network outpatient mental health benefits? Some plans have none. If the answer is no, a superbill will not produce reimbursement.
What is my out-of-network deductible, and how much of it have I met this year? You typically pay the full deductible before any reimbursement begins.
After the deductible, what percentage do you reimburse for out-of-network outpatient mental health?
Is there a session limit or an annual maximum?

Write down the answers and the date, and ask for a reference number for the call.

What we cannot tell you

We cannot tell you whether you will be reimbursed, or how much. That depends on your specific plan, your deductible, your carrier's determination, and factors none of which are visible to us.

Be careful of any program that answers this question confidently. Nobody outside your carrier is in a position to.

HSA and FSA

Many clients use HSA or FSA funds for treatment. A superbill serves as the itemized documentation those accounts typically require. Your plan administrator sets the rules on eligibility, and you should confirm with them before assuming.

Recovery coaching is not covered

Coaching is not a billable clinical service, so no superbill is issued for it. It is a separate private-pay track. What coaching is and is not covers the distinction.

Request a confidential consult →

Common questions

Do you take my insurance?

Iron Ridge is out-of-network with every carrier. If you have a PPO with out-of-network benefits, we can bill your plan out of network, or give you a superbill to submit yourself. Send us your insurance card and we will check your out-of-network benefits for you.

Will my insurance company find out I was treated here?

Not if you pay privately. Then we submit no claims, request no authorization, and do not communicate with carriers about your care. If you choose out-of-network billing or submit a superbill yourself, your carrier will know — which is your decision to make, and worth making deliberately. If you ask us to check your benefits, we contact your carrier to verify them; that is not a claim.

How much will I get back?

No one can promise an amount before your carrier processes a claim. It depends on your plan's out-of-network benefits, your deductible, and your carrier's determination. We can check your benefits so you know your deductible, out-of-pocket maximum and coinsurance before you start.

When do I receive the superbill?

You will receive it for the clinical services delivered. Raise timing on your consult call so expectations are set before you start.

Can I use my HSA or FSA?

Many clients do, and a superbill provides the itemized documentation those accounts generally require. Confirm eligibility with your plan administrator first.

Is recovery coaching superbill-eligible?

No. Coaching is not a billable clinical service. It is private pay at a separate rate.

Does using a superbill create an insurance record?

Yes. Any claim, whether you submit a superbill or we bill out of network for you, carries a mental health diagnosis and enters your record with your carrier — the same as any other claim. The privacy advantage of private pay only holds if no claim is submitted. That is a real trade-off and worth thinking about before you decide.

Questions about billing can go to intake@ironridgerecovery.com or (512) 877-8616.