Financial Assistance When Choosing a Facility
Many different types of drug and alcohol treatment centers require many different insurance policies and payments. Insurance companies historically cover partial and inadequate stays. Patients must have a recommendation from their physicians and they must go to an insurance companies’ approved facility. Rehabilitation stays are only approved once or twice a year, and therapy visits are also limited.
Therefore, if the addict can’t be helped during this time period they have to wait until the next year. With these restrictions it seems improbable that a patient will heal properly.
Insurance companies were losing money on victims of addiction and many have opted out of this kind of care, especially in the workplace. It is common for workers to sign an agreement, upon being hired that vows, “If an employee is tested for drugs or alcohol outside of the employment context and the results indicate a violation of this policy, or if an employee refuses a request to submit to testing under this policy, the employee may be subject to appropriate disciplinary action, up to and possibly including discharge from employment.” Insurance companies demand and threaten that this agreement be signed by all employees and all employees adhere to random urine tests or their policy will be null and void.
Since addicts have become a public health issue and society needs healthy productive members, it is crucial that they receive the necessary treatment. Hence, the State and Federal governments have taken over burden of care not provided by private insurance and a more effective level of care has been the result. Much of the cost situations will be eased with Patient Protection and Affordable Care Act of 2010, (ACA).
Due to the high number of addicts and the poor quality of treatment centers the ACA along with SAMHSA will also study advances in treatments, increased efforts by the treatment centers, and reviewing the cost of treatment, which should improve patient enrollment and success.
Researching facilities for previous law suits regarding insurance fraud and false statements protects you from entering a problematic center. A rehab center in Georgia is being sued for wrongful death and insurance fraud. Two different patients entered the facility for treatment. One family paid cash, in full and up front, for their daughter’s treatment. Later the director stopped the visiting mother and questioned why her insurance company hadn’t paid them. Further investigation revealed that the center billed the insurance company for $166,000.00. Two $58,000 payments listed two doctors who never heard of or consulted with the patient. The state of Georgia is pursuing the treatment center on insurance fraud.
The second patient’s family is suing the center for the wrongful death of their son. The center released him and insisted that he was cured of his addiction, always be wary of that statement, especially if the center doesn’t offer follow through visits. When he died of an overdose the parents realized the center had lied about his success. If a wrongful death law suits appear on a treatment centers legal pages then you need to reevaluate the center.
Before choosing a rehab facility check with your insurance company to see just how much they will pay; how long the stay is pre-approved for; how many therapy sessions they will cover; and if they specify a facility; next double check with the facility to make sure it accepts your insurance coverage. Also make sure the contract you sign refers to the insurance company and doesn’t have any hidden clauses that state additional out of pocket expenses. If you don’t have insurance or if your insurance only offers partial payment, make sure the facility offers a payment plan that meets your budget; educates you on State or Federal government grants; or offers scholarships that will ease your financial burden. Everyone is eager to seek help for his or herself, or a loved one, but it is crucial that you discuss the finances, gather all the information, read the small print and hidden clauses; and move forward with this information before entering a facility.