Support Programs02
.svg){kind=icon}
.svg){kind=icon}
.svg){kind=icon}
Featured Blogs05
Blog Categories10
.svg){kind=icon}
Verify insurance in under five minutes.
Most major PPO plans accepted. Tell us a few things and we'll come back with a clear summary of what's covered — no obligation, no follow-up calls unless you ask.
Admissions / PPO & Out-of-Network
PPO & Out-of-Network Coverage
What PPO out-of-network means
We're in-network with HealthSmart, MultiPlan, PMCS, and TriWest. For other plans, most PPOs include out-of-network benefits — meaning your insurance may cover a significant portion of treatment at Bliss Recovery even when your specific plan is out-of-network with us. We will determine exactly what your plan covers before you make any decisions.
How PPO Out-of-Network Benefits Work
How coverage is calculated
PPO plans typically cover out-of-network services at a reduced rate compared to in-network services. The specific coverage depends on your plan's out-of-network benefit structure, your deductible and out-of-pocket maximum, and whether the services are deemed medically necessary.
What this means for you
For many clients, out-of-network PPO coverage is substantial. We will give you specific numbers based on your actual plan after verification.
Mental Health Parity
Your rights under federal law
Federal law (the Mental Health Parity and Addiction Equity Act) requires that insurance plans provide coverage for mental health and substance use disorders on terms comparable to coverage for other medical conditions. This means insurers cannot impose more restrictive benefit limitations on addiction treatment than they apply to other medical care.
How to Use Out-of-Network Benefits
Getting reimbursed after treatment
When you complete treatment, we provide detailed superbills and clinical documentation that support your insurance reimbursement claim. We can assist you in understanding how to submit claims to your insurer after treatment concludes.
Call (323) 798-4411 to verify your specific out-of-network benefits. We will tell you exactly what your plan covers before you make any decisions.
Frequently Asked Questions
How do I know what my out-of-network benefit is?
The easiest way is to call us. We will contact your insurance carrier directly, review your specific PPO plan, and give you a clear dollar-and-percentage breakdown of what your out-of-network benefit covers before you commit to anything.
Do I have to submit the reimbursement claim myself?
In most cases, yes — out-of-network claims are submitted by the member after treatment. However, we walk you through the process, provide all required documentation, and can answer questions from your insurer on your behalf to keep things moving smoothly.
What documentation do you provide to support my reimbursement?
We provide itemized superbills that list every covered service with the appropriate billing codes, along with any clinical documentation your insurer requires to establish medical necessity. This is the exact paperwork your carrier needs to process your claim.
What is a deductible and how does it affect my out-of-network benefit?
Your deductible is the amount you pay out-of-pocket before your insurance begins sharing costs. Many PPO plans have a separate, higher deductible for out-of-network services. Once your deductible is met, your plan pays its stated percentage — often 60–80% — of the allowed amount for covered services.
Getting started is easier than you think.
Our admissions team handles everything from the first call to intake day — with care and no pressure at any step.
