NPES is a fee-for-service provider and is considered to be “out-of-network” provider for managed care. There are a variety of reasons NPES does not participate in managed care plans. Insurance companies require that all individuals receiving any type of mental health treatment receive a psychiatric diagnosis that goes into that individual’s permanent medical record to meet the criteria of “Medical Necessity.” When your insurance company obtains your mental health treatment information, confidentiality cannot be guaranteed. Most importantly, insurance companies often influence the type and duration of the course of therapy, and at NPES, you and your therapist, not your insurance company, will determine the best way to meet your objectives.