Insurance and Cost

If your insurance plan covers residential treatment for mental health disorders and addiction, it will include a component called “mental health and substance abuse coverage.” The easiest way to determine what type of mental health and substance abuse insurance coverage you have is to submit your insurance online. Once you provide your insurance details, we’ll call your insurance provider and work with them directly, to determine exactly what mental health and substance abuse benefits you’re eligible for under your plan. We then reach back out to you to discuss how the benefits are applicable for care in our program, as well as deductibles met, co-insurance and out of pocket expenses not covered under your plan.

These are costs not covered or reimbursed by your insurance company. Please call today for a phone consultation and speak with someone from our admissions team.

We’ll assist you in managing the logistics – the process is swift, simple, and free:

1. Phone consultation– Speak with an admissions coordinator about what’s been going on, so they can recommend treatment options that fit your needs and preferences.
2. Benefits check– Once you decide which treatment option you prefer, a team member will contact your insurance company to determine the details of your coverage applicable, including deductibles met, co-insurance, out-of-pocket expenses or applicable non-covered care.
3. Estimate– Using the information from the conversation with your insurance company, we’ll provide a treatment cost estimate which considers any out-of-pocket costs (outstanding deductibles, co-insurance, non-covered care). An insurance deductible is the amount your insurance requires you to pay before they begin covering the costs for For example, if your deductible is $2500, you’ll pay for the first $2500 of treatment service costs before your insurance starts paying their portion.
4. Treatment reviews– All services we provide must be authorized by the insurance company. This, however, is not a guarantee of insurance payment, as all payment is subject to eligibility and other terms of the benefit.
5. Concurrent review and continued stay certification– Most insurance policies today require ongoing communication from the treatment facility utilization management team and the managed care review department at your insurance company. This is done to ensure your healthcare dollars are being used appropriately. This communication may be required weekly or daily and is contingent upon the requirements of your insurance policy.
6. Medical necessity for care– All insurance policies have their own policy requirements, which may allow them to certify an admission or continuation of care. Each insurance policy is unique and governs how treatment stays are initially reviewed after admission and subsequently certified. Please understand that admission authorization or concurrent treatment certification is not a guarantee of payment to the treatment facility. All care is governed by insurance policy requirements, insured and dependent eligibility, and terms of the contractual agreement between the insurance company and the person insured.

It depends on your insurance provider and what it considers “medically necessary.” Our treatment team will conduct a thorough review when you enter treatment to assess your physical and mental health. We’ll then make a recommendation on the length of stay we feel is appropriate based on the severity of the presenting symptoms. We’ll communicate with and submit all the required documentation to your insurance provider. Please note that each insurance company has different requirements about what is considered “medical necessity.” Our recommendation for how long you stay is not a guarantee your insurance company will approve the same length of stay.

No. Our billing department will handle all the paperwork. We submit bills directly to your insurance provider. If you are paying privately however, we can also provide you with a superbill upon request which you can submit to your insurance company for partial or full reimbursement.

After we determine your insurance coverage for SUD and mental health treatment, we’ll provide a detailed estimate of any out-of-pocket costs you are likely to incur. We’ll also keep you updated throughout your stay should that amount change. Please note that an estimate is not a guarantee of costs.

If you don’t have insurance coverage or your insurance provider does not cover mental health and addiction treatment, you have a couple of options:

1. Self pay– You may pay costs out-of-pocket at the self pay rate.
2. Go to a free program

We encourage you to discuss this with admissions. We have relationships with many facilities and providers and are solution focused. Our commitment is to help you find the next best treatment solution should your insurance benefits or financial ability not cover the cost of residential care in our facility.