INSURANCE VERIFICATION

INFORMATION AND PATIENT PAYMENT OPTIONS

At New Method Wellness, we know that seeking treatment can be a challenging time and navigating the financial commitment can be daunting. We work to make this process as seamless as possible. We accept a broad range of insurance plans and have experts on staff to assist with questions. While no two plans are the same, insurance coverage making treatment possible can be critical. To ensure your family isn’t forced to settle, additional financing options bring state of the art care within reach. To better understand your options, we offer 24/7 telephone support and a tool to quickly verify your coverage for fast answers or you can fill out our insurance verification form.

GET ANSWERS SOONER, NOT LATER

Treatment for your family is our priority. As a family-owned and operated organization, we are committed to listening to your needs so that we can simplify and streamline the process. We are ready to work on your behalf during this difficult time. Click or call to get started now.

INSURANCE COVERAGE

Many insurance plans will cover up to 100% of New Method Wellness treatment regimens. As a first step we suggest you Verify Coverage and after learning where you stand, we’ll work together to get you the help you need.

PRIVATE PAYMENT OPTIONS

It’s a convenient option for families able to pay with personal resources. For families without rehab coverage unable to manage an unpaid balance, we’ll work with you and your provider to save you time and find your solution.

DUAL DIAGNOSIS COVERAGE – MENTAL HEALTH AND ADDICTION

Successfully addressing addiction doesn’t occur in a vacuum, it includes mental health issues. Failing to integrate a complete treatment strategy invites problems that undermine positive transformation. Our objective is recovery for life. While there is no single answer to the mental health component of treatment, the factors influencing it are quite clear.

  • It begins with the patient’s clinical diagnosis.
  • Factoring in the anticipated length of stay.
  • Determining the need for specialized services.
  • Defining the mental health and substance abuse coverage details.

New Method Wellness Accepts All Major Insurance

IN MOST INSTANCES, UP TO 100% OF OUR SERVICES ARE COVERED

Successfully addressing addiction doesn’t occur in a vacuum, it includes mental health issues. Failing to integrate a complete treatment strategy invites problems that undermine positive transformation. Our objective is recovery for life. While there is no single answer to the mental health component of treatment, the factors influencing it are quite clear.

Common Insurance Terms Defined

TO HELP YOU CONFIDENTLY NAVIGATE THE PROCESS

INSURANCE VERIFICATION

This is the essential first step where your coverage for substance abuse, mental and behavioral health is determined.  It can be confusing, but we’re here to help and contact your provider on your behalf. To save time, complete the Verification Form. We can often get back to you with details in just a day.

PRE-CERTIFICATION

Prior to entering treatment many providers will require pre-certification and ongoing authorization throughout treatment. If your policy requires this, we can help.  And even if your provider isn’t on our list of approved insurance plans, we’ll take the steps to bring them onboard.

CLINICAL INSURANCE REVIEW

Our staff is prepared to perform ongoing clinical review and any requested doctor-to-doctor calls
with your provider on the schedule required. If issues arise, we’ll file the appeals and bill your  insurance company directly at no cost to you. Our goal is to get the best possible treatment.

INSURANCE PREMIUMS

Paid monthly, quarterly or annually, this is amount individuals pay for their coverage. If your insurance is a benefit through your employer, they may pay a share. Premiums vary depending upon your coverage and type of plan; HMO or PPO, for example.

INSURANCE DEDUCTIBLES

This is simply the annual amount that you must pay before insurance begins providing coverage. Once the amount has been met, rehab insurance pays what is referred to as the Coverage Amount, a percentage of the total treatment. This amount varies with each provider and specific policy.

INSURANCE COPAYS

This standard feature of most insurance plans is a part of the agreement made with your provider and defines your plan’s benefits.  As with a visit to your doctor, there are fixed costs for certain services.  Not all insurance plans require copays but may have higher premiums.

COINSURANCE

When your rehab insurance coverage has been determined and after the deductible has been met, Coinsurance is the percentage of the total cost of treatment that the insurance policy will not cover and this is the amount that you are responsible to pay.

OUT OF POCKET EXPENSES

These expenses typically include deductibles, copays and coinsurance charges.  Out of pocket costs may also be what a doctor or clinic may require for office visits, inpatient, outpatient, or a host of therapeutic treatments. Terms are established by individual providers.

MAXIMUM OUT OF POCKET

Commonly known as MOOP, this is a limit set by your insurance company. When coinsurance paid equals MOOP, insurance companies then over 100% of the ‘allowed amount. You’ll meet that limit faster in situations where your deductibles are applied to the MOOP threshold.

ALLOWED AMOUNT

This is the daily rate insurance companies feel is appropriate for the services provided, but it may or may not be exactly what is invoiced. Note that provider Out-of-Network percentages will typically apply to the allowed amount, and not to the invoiced cost for services provided.

BALANCE BILLING

Some Out-of-Network providers invoice the patient for the difference between what was paid by the insurer and the actual invoice. Our specialists work to get you the most coverage, and determine total cost of treatment, so no unexpected billing surprises at the end.

PRIMARY INSURANCE SUBSCRIBER

This is simply the person that is named on the insurance card, but there can be a slight distinction as many younger adults that are in treatment may have coverage under their family’s insurance plan.  There is no impact on coverage, simply a name technicality.

COVERAGE AMOUNT

After you’ve met your annual deductible, the coverage amount reflects the percentage of treatment costs that will be covered and paid by your rehab insurance policy. After we’ve negotiated on your behalf, we’ll define this before treatment begins. Again, no surprises.

POLICY EFFECTIVE DATE

Determined after enrollment, this is date insurance companies begin to pay. Most have an Annual Enrollment period but offer Special Enrollment periods for a number of qualifying life events like a new baby, a new marriage, a new job, loss of a job and more.

TYPES OF INSURANCE PLANS

We work with all types. Primary categories are plans with, or without, out of network benefits as well as PPO, Preferred Provider Organizations; POS, Point of Service Plans; HMO, Health Maintenance Organization; and EPO, Exclusive Provider Organizations.

MANAGED CARE

This term is used to describe how MCOs, Managed Care Organizations, provide you healthcare services and manage treatment from simple checkups to accidents to major illnesses and also includes your network’s doctors, labs, clinics and hospitals.

SINGLE CASE AGREEMENT

When others say no way, we’ll find one. For many of our patients with substance abuse, behavioral or emotional disorders, we’ll negotiate a special contracted Single Case Agreement with their insurance company to get the rehab treatment they deserve.

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