Insurance & Paying for Treatment
When your loved one is working towards recovery, you shouldn’t have to worry about insurance coverage and how to pay for treatment. Your top priority is finding the best treatment center possible.
The insurance business can be complicated, and it can take time to get the answers you want. We’d like to take some of the burden off your shoulders by doing everything we can to make the insurance and payment process as smooth as possible.
Guiding you through the insurance process
At Insight Behavioral Health Centers, our staff will assist you in finding the information you need by doing the following:
- Serving as a liaison between you and your insurance company
- Communicating updates to you regularly
- Answering your questions
- Following the insurance claim process with integrity
- Explaining costs and coverage throughout the entire process
We are happy to do this because it’s so important to partner with a treatment provider who is trustworthy and who communicates regularly and openly with you regarding finances.
Providing our support
If you are interested in learning more about the financial process at Insight, simply call us at (877) 711-1878. A Masters-level clinician can even answer your questions and take your insurance information if you’d like. With your approval, our insurance verification experts can then contact your insurance company for you and communicate back to you in easy-to-understand terms exactly what your coverage includes and how you can help your loved one get care.
Please know that if you choose to call us with any questions regarding insurance and payment, this in no way binds your loved one to come here for treatment.
Questions to consider
You can also contact your insurance customer service representative directly, in order to better understand your insurance policy and mental health benefits. When you call your insurance company, consider asking the following questions:
- Are you covered by a PPO, EPO, or HMO?
- What care facilities are available in your area? (Unfortunately, even if your treatment provider recommends that you enter a program for behavioral health treatment, this type of treatment may not be available in your area).
- Are there travel restrictions limiting you to certain facilities for care?
- Does your insurance customer service rep understand your mental health benefits?
- Can you select an out-of-network provider or must you stay within the network?
- Are there financial risks associated with utilizing an out-of-network provider or a provider that represents as working with your insurance versus contracting with your insurance?
- Are there exclusions (care not covered by your policy)?
Our advice to you is this: you can never ask too many questions when it comes to insurance and paying for treatment.
Dealing with hurdles
You have probably heard stories about individuals being denied treatment or may have even faced insurance challenges yourself in the past.
One of the hurdles that some people face with insurance coverage is known as “utilization management.” Here’s how it works: your plan offers you specific covered benefits, but these services must be shown to be medically necessary. For example, here are some real-life scenarios that come up from time to time:
- Your treatment provider recommends residential treatment, but your insurance plan says that you don’t meet the “medically necessary guidelines” anymore. In this situation, your case will go under utilization review.
- You may understand that you need approximately six weeks of care, but your insurance company is saying that they need progress updates every few days in order for you to stay in care with continued authorization.
When these situations occur, our exceptional utilization review teams will do the work for you. They can deliver (when necessary) high-quality, excellent clinical data to your insurance provider in support of your continued stay — so that your loved one can continue working toward recovery. Our licensed clinicians work closely with insurance providers every day to communicate the most important details to them and to show them progress. If needed, our medical doctors are also available to help get expedited appeals to your insurance company.
Get to know our team.
When your loved one admits to Insight, we will educate you on every aspect of this process and will update you frequently. This process is so important. Often, these steps can make the difference between getting substandard care and getting high-quality care. Please know that we will reach out to you to discuss any significant issues that may come up.
Find the best care for you
As you prepare to help your loved one enter treatment, learn as much as you can ahead of time so that you will know exactly what your coverage includes and exactly what you will be expected to pay out-of-pocket.
And, if your insurance does not cover care at Insight, we will work with you and your family to establish self-pay rates. We will do our best to find a financial solution that allows you to get the care you need and deserve. This option is helpful if you are experiencing one of the following situations:
- Don’t have health insurance
- Lack behavioral health treatment benefits
- Have high co-pays or deductibles
- Are denied coverage by your insurance provider
- Have a limited number of treatment days
In some cases, you will be able to appeal to your insurance company for reimbursement of some of the fees.
Getting started with treatment
Before your loved one starts treatment at Insight, we will send you admissions documents that summarize your insurance benefits. These documents will also list any balances due along with deductible and co-insurance information. We will also ask you for permission to bill your insurance carrier on your behalf. When your loved one arrives for treatment, we will be here to welcome you and will answer any additional questions that you have.
We want you to have the best care and we want it to be affordable and accessible. Our goal is to be here for you, to encourage and support you and to work with you to deliver the information that your insurance company needs. We consider ourselves experts at the insurance and financial process and we look forward to working with you here at Insight.