Simplifying Out-of-Network Therapy

How OON Companies Bridge the Gap Between Private Pay and Insurance

The time to move to private pay versus insurance is right now. Therapists want to accept insurance but reimbursement rates are so low that many therapists cannot support themselves. However moving your practice to only accepting private pay means that patients cannot use their insurance and need to go out of network.  It’s a dilemma that keeps patients away from therapy and forces therapists to either take low insurance reimbursement rates or their own cash pay rates. 

According to the 2025 State of Mental Health Insurance and Marketing Report released by Thrizer, there’s a clear trend: therapists are moving away from insurance panels toward private pay models. As highlighted in the report, 26% of therapists cite administrative headaches as a primary reason for leaving insurance panels. And reimbursement rates are so low they are making therapists want to go private pay.

The answer is to use out of network (OON) payment processing companies, like Thrizer and Mentaya, who specialize in billing out of network.  Never heard of Thrizer or Mentaya? Well it’s time you did. I personally use Thrizer for a certain percentage of my clients that want private pay, but Thrizer works best for out of network (OON) coverage. Essentially I can accept my full cash rate via Thrizer, and they take care of the processing and administrative burden that comes with filing out of network bills. 

How Thrizer Works

When clients pay through Thrizer, the platform automatically submits out-of-network claims to insurance companies—no more superbills or manual paperwork. After clients meet their deductible, they pay only their copay at the time of service, with Thrizer fronting the remainder of your full fee and handling reimbursement collection. Many insurance companies pay 80% of the fees for OON providers, leaving clients to pay about 20%, depending on their insurance benefits and deductibles.

One of Thrizer's most valuable features is its instant benefits calculator, which estimates potential reimbursement before the first session. This transparency helps clients understand their financial responsibility upfront, reducing the sticker shock that sometimes accompanies private pay therapy.

The Best of Both Worlds

So using Thrizer and Mentaya, therapists can maintain their desired session rate (the report shows therapists ideally want $180-200 per session) while keeping services accessible to clients with insurance. 

The downside? These companies are not integrated into any EHR or provider platforms like Headway or Alma, but exist separately and clients will be billed via Thrizer or Mentaya. Or to put it another way, Thrizer and Mentaya do not have their own full provider platform so you will need your own EHR system while Thrizer handles all the billing. It’s not an all-in-one solution, like I would prefer, but it works great for both clients and therapists.

I definitely recommend that therapists look into using Thrizer or Mentaya in their private practice especially if they are not paneled with any insurance and prefer to be out of network. I have been using Thrizer for many months exploring my OON and private pay options and I will likely make the switch to go full private pay later in 2025.

What is your experience using these OON platforms?