There is no debate, addiction treatment is needed now, more than ever. Despite all the publicity of the “opiate epidemic”, addiction treatment providers are facing dwindling reimbursement rates. Insurance providers are scrutinizing billable rates, denying stays in treatment and opting for less effective treatment options, based on cost. Payors are attempting to avoid paying when possible and placing red tape in the way of their members. There are things addiction treatment providers can do to protect their patients and obtain the necessary treatment.
As a behavioral healthcare consultant, specializing in substance use disorders, my goal is to help providers identify revenue they are missing. There are several key areas that providers can assess to ensure the longevity of their programs. One of the key benefits of hiring an addiction consultant, is an outside set of eyes, to provide a fresh perspective. Having operated treatment programs, I can tell you we are too close to see our own blind-spots. Below are some of the areas I help providers audit and improve.
- Length of Stay
- Denials
- Documentation
- Reimbursement Rates
- Missed Revenue
- Billing Optimization
- National Accreditation
- Staffing Issues
- Utilization Reviews
- Billable Services Audits
- Outcomes Studies
Streamlining the above areas, creates a seamless process that payors are starting to demand. It is vital for treatment providers to understand there is a difference between providing great treatment and demonstrating your worth to insurance companies. With the insurance landscape changing, now is the time to tighten up your presentation to payors and collect the reimbursement rates you deserve. It is our job to help those suffering from addiction obtain the services they need.
As a consultant, I have experience working with insurance companies and helping providers obtain favorable relationships with them. I can help any provider identify ways to improve what they collect from the insurance companies they accept. For more information about the services I provide for addiction and mental health treatment providers, visit my website.
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