Insurance Reimbursement Information

Dr. Shawn Nabors: Insurance Reimbursement Information

Welcome to our insurance verification guide. The Anxiety Treatment Center of West Michigan operates as an out-of-network provider. This means we do not bill insurance companies directly. Instead, many of our clients utilize their Out-of-Network (OON) behavioral health benefits to receive partial or full reimbursement for our specialized anxiety, OCD, and panic treatment services.

To make this process as seamless as possible, we provide you with a monthly Superbill (an idealized medical receipt) that you can submit directly to your insurance company for reimbursement.

This page contains the exact provider credentials your insurance company will ask for, along with a step-by-step script to guide your call with them.

Information Your Insurance Provider Will Need

When you call your insurance company, the representative will require our official credentials to verify your specific coverage and reimbursement rates. You can provide them with the following details:

Provider Name: Dr. Shawn Nabors LPC (Licensed Professional Counselor)

Provider License Number: 6401225556

Practice Name: The Anxiety Treatment Center of West Michigan

NPI Number: 1831617281

Federal Tax ID (EIN): 811601621

Common Billing (CPT) Codes We Use

Your representative will ask what "procedure codes" will be on your Superbill. We primarily utilize:

90791 – 95 - Psychiatric Diagnostic Evaluation (Initial Intake Session)

90837 – 95 - Individual Psychotherapy, 53+ minutes (Standard Treatment Session)

90834 – 95 - Individual Psychotherapy, 38–52 minutes (If applicable)

Your Insurance Call Script & Checklist

We highly recommend calling the mental health/behavioral health number on the back of your insurance card before your first session. Use this quick script to ensure you get all the answers you need:

"Hello, I am calling to check my outpatient behavioral health benefits. I want to see anxiety specialist Dr. Shawn Nabors, who is an out-of-network provider for telehealth services."

Note: If the insurance representative tells you there are other therapists in your network with anxiety as their specialty, read this exact statement:

"While there are general therapists in my network, there are zero in-network providers in my geographical area who specialize exclusively in anxiety treatment using evidence-based protocols like ERP and specialized CBT. General talk therapy is not clinically sufficient for my condition. Because your network lacks a qualified clinical specialist, I am requesting a Network Gap Exception to see Dr. Shawn Nabors at the in-network rate."

Once you have connected with a representative, ask and note down the answers to these five essential questions:

Do I have out-of-network benefits for mental health telehealth visits?
1. Why it matters: To ensure your plan covers virtual therapy (telehealth) with an out-of-network provider.
What is my out-of-network deductible, and how much has been met so far this year?
1. Why it matters: You will likely need to pay out-of-pocket until this deductible amount is reached before your reimbursement kicks in.
Once my deductible is met, what is my co-insurance percentage or "allowed amount" for CPT codes 90791 and 90837?
1. Why it matters: This tells you exactly what percentage of the session cost the insurance company will refund you (e.g., they may reimburse 60% or 80% of their allowed rate).
Do I need a prior authorization or a referral from my primary care physician for these services?
1. Why it matters: If an authorization is required and you do not get it beforehand, they may deny your reimbursement claims.
How do I submit my monthly Superbills, and what is the time limit for submitting them?
1. Why it matters: Most companies let you upload them instantly via an online portal or mobile app, but some still require mail or fax.

Tips for Your Call:

Ask for a Supervisor: If the first representative gives you a hard time, politely ask to speak with a Behavioral Health Supervisor or a Case Manager. They understand clinical specialties much better than front-line representatives.

Get a Reference Number: Always ask for the reference number of the call and the name of the person you spoke with for your records.