Insurance & FinanceNurses are among those who might say "you can't put a price tag on health." They also know that quality is as important (if not more) than cost. At Livengrin, rates for the high-quality treatment of a nurse's drug or alcohol problem are very competitive with that of other treatment providers. We work with most insurance and managed-care companies, and as a result we can offer cost-effective care.
"Cost-effective," when it comes to addiction, is all about proper and timely treatment.
Financial considerations for services must be arranged in advance of your admission. Most forms of commercial health insurance are accepted, in addition to cash payment. Our admissions staff and financial counselors are trained to help you understand what co-pays, deductibles or limitations may apply for your plan. They work in partnership with you, the employer or agency, and your insurance provider.
Because there are many different types of insurance plans and levels of coverage, here are a few basics:
In Pennsylvania, the law requires (with some exceptions) that insurance companies and HMOs (health management organizations) writing group policies must provide for inpatient and outpatient care for alcohol and drug-related illness. If you have a policy in this state, you have the right to appropriate treatment. For other states of residence,we can assist you in determining coverage regulations.
We are responsible for evaluating a patient's medical and clinical needs. However, the decision as to the kind of care, or how much, an insurer will pay for is often made by a managed care company. This acts as an intermediary for many insurance carriers that own or utilize such a company. They will assess the information we give them and then tell us what they think is the correct level of care for the patient.
Usually, they are in agreement with Livengrin's assessment, but sometimes that's not the case. We can appeal their decision and make an argument for what we think is appropriate, but the final say about payment rests with the insurance or managed care company.
If your insurance company's determination of what they will pay for is unsatisfactory, you or your family can speak directly to them.
Useful information about the policy that you are a part of can often be found with the benefits manager at one's place of employment. Although it may be uncomfortable to reveal to this person that you are applying for benefits covering a substance abuse problem, keep your eye on the prize: treatment and recovery. An employer is likely to be paying all or much of the insurance premium for your plan, so the benefits or personnel manager will want to help you make the most of it.