Insurance Overview

Nugent Family Counseling Center Inc. is an “out-of-network” provider. If you have an insurance plan that allows you to go out-of-network (often called a “PPO” plan), you may be eligible for some level of reimbursement when seeing an out-of-network therapist. As an out-of-network provider, the Nugent Family Counseling Center Inc. can invest in the staff training and resources to provide our clients with a high level of service and expertise in treating anxiety, OCD and anxiety-related disorders.

Unfortunately, there are very few therapists who understand and know how to treat Anxiety and OCD using evidence-based treatments incorporating cognitive restructuring and exposure and response prevention therapy. Our clients seek us out because we are highly specialized and extensively trained in the most effective treatment methods for anxiety, OCD and anxiety-related problems. It is difficult, if not impossible, to find an expert in anxiety and OCD within the insurance networks since most therapists tend to be generalists.

Since every plan is different, please contact your insurance company to discuss your benefits and obtain pre-approval, if needed. As a courtesy, we do provide an insurance invoice called a “Superbill”, which might be required for reimbursement.

Do you accept my insurance?

We are only contracted with Medicare, Hometown Health (NV), Spring Health, Lyra, and Uprise Health. This practice is not “in-network” with other insurance companies so we do not accept insurance directly from them. Our practice is “out-of-network,” which means you would pay for your therapy sessions at the time of service and submit the claims to your insurance company for reimbursement. If you have mental health benefits that allow you to see an out-of-network therapist (often called a PPO), you may be able to receive partial reimbursement for therapy services. Keep in mind that insurance companies will require that you have a valid mental health diagnosis and may limit coverage by diagnosis, procedure code or number of visits. In addition, you may need to meet a deductible before your insurance company starts to reimburse you and the percentage of reimbursement is usually based on an “allowable amount,” which may be lower than the actual fee charged. Kaiser, other HMOs and Medicare will not cover any portion of the fees for an out-of-network provider. Please call your insurance company to review your benefits and obtain pre-approval (if required) before starting therapy.

We are more than willing to call your insurance company to see if our services are covered. Please reach out to us and provide us with your insurance card information. The information we will need to check eligibility are

  1. Name of the client and Insurance I.D. #
  2. Who is the subscriber
  3. What is the group #
  4. Client birthdate and the relationship of the client to the subscriber
  5. Subscribers employer
  6. name of the insurance provider and the insurance phone (E.G., “Eligibility/Benefits,” “Member Service”)

What is the process for you to submit claims for me?

As a courtesy, we can provide you with an insurance invoice. Our clients keep a credit card on file and we bill the credit card at the time of the appointment. After each session, your Therapist will generate an insurance invoice called a “Superbill”. This invoice can either be printed out at the end of the session for you to retain or can be accessed through your online confidential client portal. Once the process gets started, you should be receiving reimbursements on a regular basis. Since all plans are different, you can contact your insurance company to find out about your benefits.

However, if your insurance is not willing to cover the services, it is your responsibility to:

  1. Pay for therapy sessions in full by credit card, check or cash at the time services are delivered.
  2. Follow-up with your insurance company after the claims are submitted electronically if you have questions about your claim status and when you’ll get reimbursed.

Why should I consider going out-of-network for therapy?

While it can seem less expensive to see an in-network, insurance-based therapist, there are several benefits to seeing an out-of-network therapist at Nugent Family Counseling Center Inc.:

Specialized Skills: There are very few certified and highly trained therapists in the Silicon Valley who follow the evidence-based practices for the various forms of anxiety, depression, couples counseling, child/adolescent therapy. If you are looking for a therapist with specialized skills and training in anxiety and other mental health needs, you may need to see a specialist.

Results-Oriented: Our therapist are training in a variety of therapeutic approaches, which allows us to be client focused. While applying a structured, targeted and scientifically-based approach. While embracing the human element, we can offer an empathetic and scientific approach to counseling.

Insurance Coverage: If you have a PPO or similar plan, your insurance benefits may cover a significant portion of the cost of therapy with an out-of-network therapist. Call your insurance company to verify your coverage and benefits.

Additional Thoughts on Using Insurance

You are the most important thing in the therapeutic process. When you find the courage to call and seek the qualified help you need. We are ready to help. Many are surprised to discover Nugent Family Counseling Center Inc., can see you within a day or two, even on weekends. There generally isn’t a waiting period or waiting list, like so many other therapists.

Our mission at Nugent Family Counseling Center Inc., is to provide the most efficient and effective therapy possible. The insurance process often interferes with providing the correct treatment, quickly. This is why, as you might have already discovered, many therapist are booked out for a few months and if you do get into see a therapist. You might have to waited a month in-between sessions. Additionally, many therapist who accept insurance are generalist. But most likely, when you are ready to see a therapist its not for general needs. Rather you needs a specialist for depression, anxiety, marital issues, sex therapy and so forth. Because we are “out of network” we can investing in the training our are clinicians to address your specific needs. Many clients report to having more success in just a short period of time then the years of treatment they received with their insurance provided therapist.

As a private practice, we are empowered as experts to use the full extent of our training to provide you with the treatment that is BEST for YOU. Unfortunately, if we were to work directly with insurance, they will have access to your information and dictate how treatment should be provided.

1. Your therapist has to diagnose you to get you reimbursed.

2. Your records are not protected.

3. Your care is dictated by the insurer.

4. Insurance almost never pays the full fee.

5. Insurance limits your options. Confession of a Therapist

Further Reading: Frustrated You Can’t Find A Therapist? They’re Frustrated, Too

Further Reading: Single Mom’s Search For Therapist Hampered By Insurance Companies

How much does therapy cost at the Nugent Family Counseling Center Inc.?

The fees vary by therapist and range from $175-$300 for 50-minute therapy sessions. Fees for the initial intake session are $210.

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