When you or a loved one is in need of drug or alcohol treatment, the last thing you want to worry about is how you’re going to pay for it. Finances shouldn’t be a barrier to anyone getting vital, life-saving help. And even if the money for treatment IS available, getting access to it can be difficult. If you’ve ever had to submit a claim or been denied coverage of a claim for your home, car or health, you know the process can be frustrating, to say the least. Add the stress of addiction to the mix and unraveling the maze of coverage can easily frazzle already frayed nerves. Fortunately, Foundations Recovery Network (FRN) has an entire team that is trained to walk you through every step of the process.
Pre-certification Is Key
You may think you can handle this part of the process on your own, but a pre-certification often requires a certain level of expertise. It may sound straightforward enough, but it’s not as easy as jumping on the Internet or looking through your insurance documents to determine your coverage level. In some cases, you may find a provider is “out of network” and have no way to determine if you can still go to that facility. That’s why it’s a regular part of our intake process to determine your medical needs and then call your insurance company directly. At this time, we get specific information on treatment coverage as it applies to your situation. We then use this data to help you determine which program is the right fit based on coverage and other financial considerations as well as your specific treatment needs.
Walking You Through the Maze
Should you turn right or left? Do you need this option or that one? Addiction treatment coverage can seem like a maze, and it’s easy to get turned around or hopelessly lost without an experienced guide. This is not a topic most people have time to research before they need it, so when these questions do come up, decisions usually need to be made immediately about treatment and how to proceed, adding pressure to an already confusing process.
We’re here to help you through your substance use issues, but also to advocate on your behalf to your insurance company to get you all the treatment you need.
It may seem needlessly complicated, but insurers and employers are actually just trying to comply with a complex set of insurance by-laws. At FRN, we’re familiar with the process and so we’re prepared to provide the detailed information they need to get the most informed picture possible. That’s why we’re not just here to help you through your substance use issues but to advocate on your behalf to your insurance company to get you ALL the treatment you need. By placing a call and having your insurance card in hand, we can help sort through the myriad options and how each one affects your coverage.
What the Parity Act Means for You
You may not even know that recent legislation has made it easier to get treatment costs covered for mental health and addiction. The goal of the Parity Act is to equalize coverage for those issues and other medical procedures. For years, there have been restrictions on this treatment that didn’t apply to other disorders, and the unfortunate result was that it kept those in need from getting help. The problem was rooted in prejudice and misinformation about the cost of treatment and the nature of mental illness and substance abuse.
There are currently more than 25 million untreated Americans with addiction, and they may now have the opportunity to seek help as part of the estimated 113 million Americans who will be positively affected by The Parity Act (aka HR 1424). But what does it mean for you personally? Well, you may now have improved coverage for addiction treatment, but you need to reach out to an expert in order to get details and explore your specific options.
There is solid science indicating that mental illness and addictive disorders are diseases. Just as with other diseases and disorders, recovery from addiction and mental disease is possible when effective treatment is available, and the truth is that money spent on treatment may also save the U.S. billions annually in the criminal justice, welfare and healthcare systems.
This isn’t about making a single phone call and then being handed off. Throughout the treatment process, staff participates in what is called “utilization review,” informing your healthcare provider at each step along the way to seek approval for any new phase of treatment (for example, as you transition from detox to residential care to outpatient treatment, if needed). This allows us to advocate for you if your provider questions the necessity of a next step or the length of stay at the current level, which is fairly common. It also helps eliminate any ugly surprises down the road. In addition, we start discharge planning from the day you arrive, making plans for any extended care before you ever leave our facility.
If treatment is needed, don’t let fears about coverage or insurance issues keep you from seeking help. If you or a loved one is struggling with an addiction and a co-occurring disorder, call us today. We’re available 24 hours a day, seven days a week and can provide information on treatment programs, help with insurance and answer questions about the treatment process.