Our hope is that every NOCD Therapy Member leaves their therapy sessions feeling encouraged, motivated, and on a path to conquering OCD. But our obligation to you doesn’t end when you leave the session. In between appointments, you engage with therapy exercises, track your progress, read helpful content, and communicate seamlessly with your NOCD Therapist or member advocate team.
This crucial time between sessions is also when you deal with administrative parts of the therapy process, like paying your bills. When you start treatment, whether you’re able to use your insurance to pay for NOCD Therapy or you’re paying out of pocket, you get your first bill after you start therapy.
And because insurance partners may take a long time to process claims, it’s not always possible for you to know the cost of a session before you get a bill. Other unanticipated challenges might emerge, like having your health insurance plan outsource behavioral health services to a different entity without properly explaining it on your benefits card. Understandably, this can cause frustrating situations.
Learning to conquer OCD is difficult on its own, so these uncertainties in the billing process can make the journey even more stressful. Many of us at NOCD have even experienced the same challenges ourselves. As a result, we recognize that it’s our responsibility to support you throughout the billing process, especially when it breaks down. While these issues only impact a small number of Members, we hold ourselves to a high standard and are committed to providing a VIP experience for everyone we serve.
We’ve used a Member-first, data-driven approach to investigate these issues and learn why they’ve occurred. We’d like to share our findings and explain how we’re evolving our product and processes to address each billing-related challenge going forward.
Overcoming challenges with verifying insurance eligibility
When you schedule a NOCD Therapy session and elect to use insurance, we send your information to your health insurance company for verification. Often, this process happens within a day or two, but sometimes sorting it out can take several phone calls to your insurance company, which NOCD handles on your behalf. It all depends on your plan, and sometimes your insurance provider can’t clarify whether you’re covered even after several calls.
Coverage uncertainty can be particularly challenging, because most of our Members prefer to meet with their therapist as soon as possible. Our core company value is “members first,” so we’ve made the decision to still serve members whose plans are slow to respond, especially for plans we work with frequently. Most of the time, this allows us to offer our Members a better experience, but sometimes we learn that a plan has unexpectedly denied eligibility after therapy has started. A Member’s insurance might have changed without communication, or they might have a plan that outsources their behavioral health services to another entity. It’s certainly not the norm, but when it happens it can create a severely poor experience.
Some Members feel misled and disheartened when they’re denied eligibility, particularly if they’ve already bonded with their NOCD Therapist and are forced to restart treatment with someone else, or are unexpectedly responsible for the full cost of therapy.
This situation is unacceptable, and we’re set on fixing it. Now, Members can upload their insurance information and begin the verification process with their insurance provider even before speaking with us on their first intake call. If they still need help, a member of NOCD’s Member Experience Team will offer personalized support to help them understand their eligibility status prior to seeing their therapist.
Even if a Member’s eligibility is denied, we may be able to connect them with a therapist outside of NOCD whose expertise we trust, or create a payment plan to undergo treatment as affordably as possible.
Although we can’t improve every break in the system, we refuse to leave our Members hanging if unexpected challenges occur.
Understanding per-session costs, deductibles, and copays
Even when Members are eligible to pay for NOCD Therapy using their insurance, understanding per-session costs can still be challenging. Complex factors such as deductibles, copays, coinsurance, and other differences in plans make it especially difficult to know exactly how much a session will cost. This variability makes it hard to predict the exact cost of each therapy session upfront, leading to confusion and frustration when a bill ultimately arrives.
Using insurance for NOCD Therapy: a primer
- Say a Member completed 10 NOCD Therapy sessions that cost $1,700. If their deductible is $1,000 and they haven’t paid for any healthcare services yet, they’ll need to pay the first $1,000 out of pocket. After meeting their deductible, their insurance might cover part of the remaining $700, depending on their coverage.
- Under some plans, Members are still responsible for coinsurance after they’ve met their deductible. For instance, if their plan covers 80% of the costs after the deductible, they’ll still be responsible for the remaining 20%. In the example above, the Member would owe $140 after meeting their deductible, while their plan would cover the remaining $560. Although not all plans require coinsurance, it’s important to understand what your financial responsibilities will be.
- Most of our Members are only required to pay a copay, which typically costs anywhere from $5 to $50 per session. After their deductible is met for the year, many members who don’t have coinsurance only pay a copay for NOCD Therapy.
- Health insurance companies set the rules around coverage for NOCD Therapy, and real-time access to each Member’s deductible, copay, and coinsurance information varies by plan. NOCD works with Members to navigate this complexity and ensure they have a comprehensive understanding of their financial responsibilities before they begin therapy, in hopes of making the process as transparent and stress-free as possible.
Here’s what we’ve done to make billing easier at NOCD:
- We’ve released a new Billing Resources Guide. This brand new page contains everything Members need to know about paying for NOCD Therapy, from what to expect at each stage of their journey, to how to interpret their invoices. It also contains an extensive list of FAQs, providing answers to the most important questions we’ve heard from our Members.
- We’re making sure Members receive critical updates about paying for treatment. Our Members should never have to go searching for information about billing. When we have updates that are critical to Members’ treatment—for example, if their insurance coverage status has changed or they’re being billed for several sessions at the same time—we’ll use text, email, push notifications, and in-app alerts to make sure the message reaches them.
Navigating delayed bills
One particularly challenging experience we hear about from Members is receiving delayed bills, and the impact delays have on managing personal expenses.
A couple years ago, because demand for NOCD Therapy increased rapidly from 2020 through 2022, we weren’t able to increase the scale of our operations as fast as we needed to, which at times delayed the claims we sent to health insurance companies for processing, and caused our members to receive their bills later than anticipated.
Over the past two years, we’ve built processes and systems to submit claims on a large scale, and send Members timely bills. We saw improved results in 2023 and 2024, and we’re confident this problem is solved now.
More recently, there was a cybersecurity incident at Change Healthcare, a company that manages payment for major insurance plans. While the incident had no direct impact on NOCD’s care delivery or data security operations, it led to delays in processing claims for many thousands of healthcare providers and patients across the country. As a result, some NOCD Therapy Members received delayed bills.
Going forward, when external issues like these happen, we’ll make sure Members understand how their billing might be impacted, and they can reach out to our Member Experience team with any concerns. We’ll reach out over email, text, push notifications, and in-app alerts to specifically address these types of situations.
We’re committed to continuous improvement
While we believe we’ve made important steps in the right direction, we’re dedicated to constantly improving the NOCD Therapy Member experience. What we’ve accomplished so far is just the start. The healthcare landscape is always evolving, and we remain committed to making our billing process as smooth as possible so our Members can get better and stay better.
This starts with gathering genuine, constructive feedback from our Members. If you have any questions at all about the billing or payment process, we encourage you to take a look at the Billing Resources Guide or reach out directly to your Member Advocate in the NOCD app. And if you can’t find the answers you’re looking for or want to connect with a real person, please email us at care@nocdhelp.com—your feedback is what allows us to keep improving.
Sincerely,
Stephen M. Smith
Co-Founder and CEO