How SCAC Works With Your Insurance

When looking for a treatment facility that meshes best with you and your life, money should be the last thing on your mind. Insurance and financial costs, unfortunately, are the reality for many people who are seeking help. However, at the Southern California Addiction Center, we focus on using the insurance you currently have to make for a worthwhile experience at our facility.

The fact of the matter is most insurance teams are not well established and do not understand the ins and outs of a treatment center’s operations. When there is no insurance department, you are left unsure when it comes to reimbursements and the services that are offered.

How SCAC Works With Your Insurance

One key process our insurance team can do is a Utilization Review (UR). This review allows authorization for services quickly and effectively. Because a treatment center stay can last a lot longer than a doctor’s checkup (between 30 to 180 days), there is a lot more to understand when it comes to your needs. Typically, insurance companies will allow an individual 4 to 14 days of service in a treatment center. We do our best to work with your insurance to cover any additional stay needed.  

Treatment at SCAC falls into windows of 30, 60, 90, and 120 days of treatment, depending on the severity. Our insurance team can help to authorize rehabilitation services and guarantee that the patient is able to stay the full number of days. This will also allow for one-on-one physician focus on what an individual requires. Based on statistics, almost 97% of patients need a physician’s help to get their money reimbursed to them through insurance when using our facility.

The Utilization Review Process

When delving into the Utilization Review, there are few things to understand about the process. First, we speak with your insurance to make sure that you are covered for your stay. Next, when you arrive at the facility, there will be a psychological and physical evaluation to determine your current status. This stage will help us relay information to your insurance company as to why you require treatment at this time.

Subsequently, the insurance company will usually allow for the standard 4 to 14 days of treatment. During this time, we will continue to communicate with your insurance company to give updates on your status and let them know if you need more time at the facility.

Upon the completion of the first window of treatment, another round of communication will be had to decide if you can be discharged or if more time is needed. We also do our best to continually update the patient’s family. Lastly, if more days are needed, physician records and updates will be given to your insurance company. This will allow you peace of mind, when focusing on your treatment.

We do our best to make sure that there are no surprise bills a the end of treatment, so that the patient can begin their new, sober life. In an event that a surprise bill does arise, our team works hard to reimburse you for your costs. This is how sure we are we can help you monetarily during this process.

Helping Patients Get The Help They Need

After you decide on treatment, we quickly bill the insurance company, so payment can be received, and there is no miscommunication. We have a 2-day policy, where we will bill the insurance company every 2 days with new information. This way, there is a clear idea of exactly what is owed. This is important because we want to know if an insurance company will be able to pay your bills because nothing is worse than a company billing after the fact, and your insurance won’t pay any of the rehab cost. Then, you end up with an enormous bill. Our job is to eliminate financial stress, as much as possible.

Out of Network Options

If your insurance is out of our network, you still have options. If you are not sure if you are covered, give us a call because we can direct you to the right place. For verification sake, we will need only 40 minutes of your time to ask over 100 questions to ensure success for you and your coverage. No treatment center’s insurance staff should take hours of your time. We pride ourselves on being an honest facility that hires employees with integrity. Also, we want you to know everything up front, so there are no surprises down the road.

As a treatment facility, we believe it is important to have out-of-network options. Because of this, we will not limit treatments. Moreover, our reimbursement options are  better, as well. This gives us an opportunity to use techniques like yoga and music therapy to help with the whole body experience. Lastly, out-of-network providers can extend a stay past 30 days. This gives patients more flexibility at the Southern California Addiction Center.

When it comes to insurance companies, here are a few, but not all, that we have an excellent reputation with:

• United Healthcare
• Beacon
• Cigna
• GEHA
• IBF
• UMR
• Providence Health
• Anthem Blue Cross
• Select Health
• HMA
• Humana

We take a stance of if a person needs help, they should not be turned away.  We keep full copies of the patient’s benefits, either online or in hard copy so we can always easily answer any questions that the patient, or the insurance company may have. A patient will never be forced to leave our facility if they do not feel ready. We will not let an insurance plan will not drop you off altogether and leave you to dry.

With this information in mind, you will be well on your way to success. Knowledge is truly power, and the more you know, the better decision you will make for the recovery of you or your loved one. Our patient’s health is the top priority at the end of the day.