Understanding your coverage and out-of-network benefits
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.
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.
We are contracted (in-network) with the following:
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.
Important: 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:
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:
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.:
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.
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.
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.
The fees vary by therapist and range from $175-$300 for 50-minute therapy sessions.
Fees for the initial intake session are $210.
Your therapist has to diagnose you to get you reimbursed.
Your records are not protected.
Your care is dictated by the insurer.
Insurance almost never pays the full fee.
Insurance limits your options.
Our team is here to help you understand your insurance benefits and answer any questions you may have about payment options.