Billing Services – Access to Coverage

Administrative Billing Submission

Access to Coverage provides administrative billing submission services for clients and therapists who have eligible out-of-network claims or approved coverage arrangements.

Our role is limited to coordinating claim submissions and related administrative steps using authorized provider information. Claims are submitted under the therapist’s credentials through a secure, HIPAA-compliant billing platform.

Insurance payment decisions are made solely by the insurance carrier.

How Billing Works

Step 1 — Billing Enrollment

Complete the billing intake form and upload required documentation.
You may be asked to provide:

Insurance plan information
Therapist contact information
Superbills or therapy invoices
Authorization to perform administrative billing services
Payment method for administrative billing fees

Step 2 — Therapist Authorization

Before any claim is submitted, therapist authorization is required.
This includes:

Written authorization permitting Access to Coverage to submit claims as a billing agent
Verification through a HIPAA-compliant billing platform
Confirmation allowing claim submission using the therapist’s NPI and billing credentials

Claims are never submitted without therapist approval.

Step 3 — Administrative Claim Submission

After authorization is confirmed:

Documentation is reviewed for completeness only
Claims are submitted electronically through a secure billing platform (Claim.MD)
Submission confirmation is provided to both the client and therapist

Access to Coverage does not create, alter, or modify clinical or billing information prepared by the therapist.

Step 4 — Insurance Processing

The insurance carrier reviews and processes claims according to plan rules, eligibility requirements, and medical-necessity determinations. Access to Coverage does not participate in payment decisions, claim adjudication, or reimbursement determinations.

Payment Flow (Important)

Insurance payments, if issued, are sent directly to the client or therapist according to the insurance plan.

Access to Coverage does not receive, hold, redirect, or distribute insurance reimbursement funds.

Billing Fees

Flat Administrative Fee: $50 per claim submission

One submission may include multiple sessions listed on a single superbill

No subscriptions or long-term contracts

Charges apply only when a claim is submitted

Billing fees are charged solely for administrative submission services and are not contingent upon insurance payment or reimbursement outcomes.

Fees compensate administrative billing coordination services only and are not payments to any insurance company.

Required Documentation

To use billing services, clients must provide:

Services performed by a licensed therapist
Superbills or invoices showing:
- Session dates
- CPT codes
- Diagnosis codes
- Session fees
Therapist contact information
Current insurance information

What Access to Coverage Does Not Do

Access to Coverage does not:

Submit claims without therapist authorization
Guarantee reimbursement or payment
Influence insurance payment decisions
Modify therapist clinical documentation or coding
Collect or distribute insurance payments
Act as a healthcare provider or insurance company
Replace a therapist’s internal billing services

Compliance & Plan Requirements

Access to Coverage acts solely as an administrative billing agent.

Claims are submitted under the therapist’s NPI and tax identification number
The therapist remains the rendering provider responsible for clinical services and billing accuracy
Payment determinations are made exclusively by the insurance carrier

Certain Medicare or Medicaid managed plans may have additional restrictions, and service structure may vary depending on plan requirements.

Eligibility

Billing services are intended for clients who:

Have approved coverage arrangements, or
Have insurance plans that allow out-of-network claim submission.

Final Disclosure

Access to Coverage provides administrative billing coordination services only.
We are not an insurance company, healthcare provider, or law firm.

Coverage, reimbursement, and payment outcomes are determined solely by the insurance carrier and are not guaranteed.

Claim submission does not guarantee reimbursement.

Access to Coverage is an independent administrative advocacy and billing coordination service and is not affiliated with any insurance carrier. Insurance coverage and payment determinations are made solely by the insurance carrier.