Common Questions

No. Gloaming is out of network with insurance plans, so you pay Dr. Dugan directly and can ask your plan to reimburse you. We do not bill Medicare or Medicaid. If you want a clinician who does, tell us and we will help you look.

A superbill is an itemized receipt we send each month that you can send to your plan, which may reimburse part of the cost. It carries a diagnosis code, which your plan will see. Your plan decides whether it pays and how much.

If you pay without insurance, you have the right to receive a Good Faith Estimate of what your care will cost before you start, and we give you one in writing. If a bill is $400 or more above the estimate, you can dispute it. The estimate is not a contract. You can read more at cms.gov/nosurprises.

Your fee for a session is given to you in writing before you book. A limited number of reduced-fee sessions are held each month; ask when you write to us. The How fees work page has the rest.

Yes. Cards from a health savings or flexible spending account work for sessions. Check with your account's administrator about what it covers.

We ask for 48 hours' notice to cancel or move a session. Later changes may be charged the session fee, and if something urgent comes up, we will talk it through.

It lasts 50 minutes. We talk about what you want from therapy, what your nights and days are like, and what pace feels right. You do not have to tell your whole story. The Your first session page walks through it.

Sessions are 50 minutes, usually weekly at first. How long you stay is your decision, and your clinician sets the pace with you. We check in every few sessions about what is helping.

CBT-I is cognitive behavioral therapy for insomnia, a structured method with a sleep diary and a plan for your nights. Dr. Dugan adds it where it fits, and her training is through the Society of Behavioral Sleep Medicine. It is not a sleep study or a medical diagnosis; if you think a medical condition affects your sleep, see your physician.

Dr. Dugan is licensed in Oregon. Sessions are in person in Portland, or by video for clients who are in Oregon when we meet. We cannot see clients who are in other states.

What you tell your clinician is confidential, with limits the law sets, such as a risk of serious harm to you or someone else, or a report the law requires. Dr. Dugan explains these limits at your first session.

Dr. Dugan works with adults, 18 and older. If you are looking for care for a teenager, tell us and we will help you find a clinician who sees teens and can explain how consent works in Oregon.

Call or text 988, the Suicide and Crisis Lifeline, any time. In an emergency, call 911. This practice is not an emergency service, and messages are read on weekdays.