Out-of-Network Physical Therapy: How Reimbursement Works

1. We’re Out-of-Network, But You Can Still Get Reimbursed

ONYX is an out-of-network provider, meaning we don’t bill your insurance directly. However, many patients receive partial reimbursement for their visits by submitting a superbill to their insurance company.

2. What We Provide

Upon request—we’ll give you a “Superbill”, a detailed receipt that includes:

• Your therapist’s name, credentials, and NPI/license number
• Our clinic address and tax ID
• The CPT codes (billing codes) for your treatments
• The ICD-10 diagnosis codes from your evaluation
• The dates, duration, and fees for each visit

We also call your insurance company on your behalf, and provide you with your out-of-network benefits. We will tell you what your estimated reimbursement rate will be. 

3. How to Submit a Superbill

Before submitting, call the number on the back of your insurance card (usually “Member Services”) and ask this question:

Where should I send a superbill for reimbursement?

Each insurer has its own process, but most allow:

• Online submission: Upload your superbill through your insurance member portal.

• Mail or fax: Send the superbill to the claims address listed on your insurance card

• App submission: Some insurers use mobile apps for claim uploads.

• Email submission: Some insurers have you email a pdf version of the superbill

Make sure to keep a copy of your superbill and any claim confirmation for your records.

Take notes during your call and record the representative’s name and date.

4. What Happens Next

After submission, your insurance company will review your claim and—if eligible—send you a reimbursement check or apply the payment toward your deductible. Make sure to provide them with your address, so they know where to send the check. 

5. Quick Summary

• You pay ONYX directly for care.
• We give you a superbill with all required details.
• You submit it to your insurance for possible reimbursement.

Discliamer: While ONYX may assist in obtaining information about your insurance coverage and benefits, please understand that any details we provide are not a guarantee of coverage or payment. Insurance policies are complex and can change without notice.It is your responsibility as the patient to verify your own insurance benefits, including co-pays, deductibles, co-insurance, authorizations, and network status. You are financially responsible for all charges incurred for services rendered, regardless of insurance coverage or reimbursement.