Insurance & Finance
The best and most cost-effective way to deal with addiction is proper and timely treatment. The admissions staff and financial counselor will work with you to achieve the best level of care possible.
Please know that financial considerations for a patient's treatment must be arranged in advance of your admission. In addition to cash payment, we accept most forms of commercial health insurance. Our admissions staff is trained to help you understand what co-pays, deductibles or limitations may apply for your plan. Patients or referral sources should investigate this prior to admission. A financial counselor is here to help.
There are many different types of insurance companies, plans and levels of coverage. Obviously, we can't explain the exact details of your plan here - but here are a few basics:
The law in Pennsylvania requires (with some exceptions) that insurance companies and HMOs (health management organizations) that write group policies in the Commonwealth 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.
Many insurance carriers now own, or contract with, "managed-care" organizations. These companies assess the information given them by doctors and other healthcare providers and then tell us what they think is the appropriate level and type of care a patient should get.
Livengrin takes responsibility for evaluating a patient's medical and clinical needs, by using nationally-recognized criteria. However, in today's insurance climate, we cannot always decide what kind of care, or how much care, an insurance company will pay for. This decision is often made by the managed-care company used by your insurance carrier.
Often they are in agreement with our assessment of a patient, sometimes not. We can appeal their decision, and fight for what we think you need, but the final say regarding payment is up to them.
If you are unhappy with your insurance or managed-care company's determination of what they will pay for, we can usually provide you with the contact information so that you or your family can speak directly to them.
The benefits manager at one's place of employment can often give you useful information about the policy that you are a part of. Although it may be uncomfortable to reveal to this person that you are applying for benefits covering a substance-abuse problem, that can be a small matter compared to how important your treatment will be for you! Because the employer pays all or most of the insurance premium for your plan, the benefits or personnel manager will want to help you make the most of it. Read more about support in the workplace.
