This Practice Is Out of Network
This practice does not participate with any insurance plans and is out of network with all insurers. The practice has no
contracts with insurance companies, does not bill insurance directly, and does not accept assignment of insurance
benefits. Payment for services is the responsibility of the client (or, for a minor, the responsible parent or guardian)
and is due at the time of service according to the practice's fee schedule.

Monthly Superbills
To help you seek reimbursement from your insurance company, the practice will provide a superbill once per month.
Superbills for a given month are typically issued at the beginning of the following month and are made available to
you through the SimplePractice client portal.
A superbill is an itemized statement containing the information insurers generally require to consider reimbursement,
including the dates of service, the service (CPT) codes, a diagnosis code, the fees you paid, and the practice's provider
identifiers (NPI and Tax ID). A superbill is not a bill — it is a receipt for services you have already paid for.

Submitting the Superbill Is Your Responsibility
It is your responsibility to submit your superbills to your insurance company to request reimbursement under your
out-of-network benefits. The practice provides the superbill; it does not submit claims on your behalf, and it does not
manage, track, or appeal insurance claims.
Any reimbursement is a matter between you and your insurance company. If your plan reimburses out-of-network
care, the payment goes directly to you, not to the practice. The practice is glad to provide reasonable additional
documentation on request, but the responsibility for submitting claims, following up, and handling any denials or
appeals rests with you.

Payment Is Due Regardless of Reimbursement
Your fee is due at the time of service whether or not, and whenever, your insurance reimburses you. Because
reimbursement comes to you separately from your insurer, it does not affect what you owe the practice, and it is
never a condition of payment. The practice cannot reduce, delay, or waive fees based on the status of an insurance
claim.