What people ask us most

Vertex is out of network with insurance plans, so you pay for each session yourself and we give you a monthly receipt you can send to your plan. Nathan is not enrolled with Medicare or Medicaid. If you want someone who bills your plan, we will give you names of colleagues.

A superbill is an itemized receipt, with the dates and kind of each session, that you can send to your plan. It may reimburse part of out-of-network care. It carries a diagnosis code your insurer can see, and your plan decides whether it pays anything.

If you pay without insurance, you have the right to a written estimate of your costs before care starts. We give you one before the first session. If the final bill is $400 or more above the estimate, you can dispute it. The estimate is not a contract.

The fee depends on the kind of session and how long it runs. We give it to you in writing before you start, and there is no contract or payment in advance. The fees page explains each step.

Yes. You pay by card at the end of each session, and HSA and FSA cards work like any other.

It lasts 60 minutes. Nathan listens, explains how exposure and response prevention works, and goes over the limits of confidentiality and the possible risks and benefits of therapy. You decide whether to go on, and at what pace. You do not need to prepare anything.

Sessions run 50 minutes, and many people begin weekly. Nathan sets the pace with you and does not promise a number of sessions.

Exposure practice is planned with you in small steps, and nothing happens without your say. You hear what a step is, and why, before you take it. You can pause or stop at any point.

Nathan is licensed in North Carolina. He sees you in person in Durham, or by video if you are in North Carolina during the session. If you are elsewhere, we cannot see you by video, but we will help you look for someone.

Call or text 988, any time, or call 911 in an emergency. Messages to Vertex are not read around the clock, so do not wait for us to answer.

We keep your records private and share them only as the law allows. Before you start we explain the limits in writing, in plain words.

No. Vertex sees adults, 18 and older. If you are looking for someone for a teen or a child, write to us and we will give you names.

We ask for 24 hours' notice to change or cancel an appointment. If something comes up sooner, write or call and we will find a way through it together.