Out of Network Insurance Facts

What Does OON Mean:

OON=Out of Network. Out of network insurance plans differentiate between how much financially is covered or reimbursed by in and out of network providers. By using an OON provider, you as the client/patient take on the financial responsibility of payment. Not all insurance plans reimburse for OON providers. Check if telehealth has a different rate too.


Your insurance will ask you to file for reimbursement by mail with a specific form or through their insurance portal.


If you submit to your insurance for reimbursement, there will be a diagnosis that gets sent with your superbill to the insurance. This is a requirement your provider has to do for insurance to recognize the medical service.

What's a Superbill?

A superbill is a statement an out of network provider can give you that you will be able to use to submit to insurance. On the superbill, you will see the provider's information as well as the services provided, dates of service, diagnosis code, and cost.

Info Needed:

When you go onto your insurance portal or call your insurance to check your benefits, you will need the following information:

  • Provider's name (legal and business) and address of business
  • Provider's Tax ID/EIN
  • Provider's NPI number (also called Provider's ID number)
  • Services code-called "CPT code"

If you have questions or concerns, please reach out.

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