Gap Exception Patient Guide
A Tool For Out Of Network Therapists
Help Make Therapy More Affordable
If you are an out-of-network therapist, you may think your patients are stuck paying out of pocket or using their out-of-network benefits. There is another option you may not know about. They can apply for an out-of-network exception, a.k.a gap exception, with their health insurance to help cover the costs.
Use our guide as a handout to easily educate your patients on gap exceptions, give instructions on how to apply, and give them the details they need from you.
What Is A Gap Exception?
With a gap exception, sometimes called an out-of-network exception, insurance covers out-of-network therapy as if it were in-network due to the "gap" in their network of providers.
For example, if a patient needs to see a therapist specializing in OCD but there are no therapists in-network for that, they could qualify for a gap exception.
The application process can be confusing and is not usually promoted, which is why we created our handy guide to use as a resource in your practice.
What's Included In The Guide?
What You Get: A reusable PDF to use as a handout in your practice that includes:
Patient education and FAQ's
Step-by-step instructions with tips for your patients on how to apply for a gap exception and what to expect
Digital, fillable form to provide the codes and details needed for the patient's application