Getting insurance to cover substance abuse treatment can be tough. If you or someone you care about needs help, you might have many questions about how to use your insurance. At Asheville Recovery Center, we understand these challenges and have developed a system to make the process easier for you or your loved ones. In this blog, we will explain how Blue Cross Blue Shield (BCBS) insurance can be used for substance abuse treatment and how our Utilization Review Department helps fight for the necessary treatment time for our clients.
What is Blue Cross Blue Shield (BCBS)?
Blue Cross Blue Shield (BCBS) is one of the largest and most recognized health insurance providers in the United States. They offer many different insurance plans that cover various medical needs, including substance abuse treatment. BCBS operates through a network of independent and locally operated companies, providing coverage to millions of Americans. Due to this somewhat broken up factions not every BCBS entity operates the same way which means it can be extremely difficult to understand how to navigate what your coverage looks like.
Challenges in Getting Drug Rehab Covered
While BCBS offers coverage for substance abuse treatment. Most people don’t understand that getting approval for rehab services can sometimes be difficult and frustrating. Here are a few common obstacles:
- Different Insurance Plans: BCBS offers many plans, and benefits and coverage can vary a lot. Some plans might cover extensive rehab services, while others offer limited coverage. We can run a VOB or Verification of Benefits to confirm what coverage your plan offers.
- Preauthorization Requirements: Many BCBS plans require preauthorization before they will cover substance abuse treatment. This means you need approval from BCBS before starting treatment, which can take time. We have found a bit of a short cut with this method. In most situations at Asheville Recovery Center you can start your treatment and we can backdate the authorization start date.
- Medical Necessity: BCBS often requires proof that the treatment is medically necessary. This involves providing detailed documentation and assessments from healthcare professionals. Our UR Department (The department responsible for conveying to the insurance companies WHY the client needs help) have perfected the ability to clearly explain the medical necessity.
- Coverage Limits: Even if coverage is approved, there might be limits on how long the treatment lasts or the types of services covered.
Keep reading to hear more about HOW they determine when a clients time in treatment is no longer covered.
How Asheville Recovery Center Can Help
At Asheville Recovery Center, we understand these challenges and have developed a strong Utilization Review Department to help you navigate them. Here’s how we can assist you in getting the necessary treatment time covered by BCBS:
Expertise in Insurance Navigation
Our Utilization Review Department consists of experts who know the details of almost every BCBS insurance plan. They stay updated with the latest policies and requirements, ensuring we can provide you with accurate information and guidance.
Comprehensive Preauthorization Process
We handle the preauthorization process carefully. Our team gathers all necessary documentation and submits detailed preauthorization requests to BCBS. This includes medical records, assessments, and treatment plans that show that the client is in need of the addiction treatment.
Personalized Treatment Plans
Each client at Asheville Recovery Center receives a personalized treatment plan tailored to their specific needs. This individualized approach not only improves the effectiveness of treatment but also helps in securing insurance coverage. A detailed and personalized treatment plan shows BCBS that the care provided is essential for the client’s recovery.
Continuous Communication
Our team maintains continuous communication with BCBS typically weekly throughout the treatment process. We provide regular updates on the client’s progress and adjust treatment plans as needed. This ongoing communication helps in securing extended coverage when necessary.
Advocacy for Clients
We fight hard for our clients to ensure they receive the full extent of their insurance benefits. If a claim is denied, we don’t give up. Our team appeals denials and works hard to get the coverage approved. We believe that everyone deserves the chance to heal, and we fight to make that happen.
The Importance of In depth and Long-Term Treatment
Substance abuse treatment is not a one-size-fits-all process. Beneficial treatment involves various stages and services, including detoxification, therapy, counseling, and aftercare. Here’s why each stage is crucial:
Detox
Detox is the first step in the recovery process. It involves clearing the body of harmful substances under 24/7 medical supervision. Detox can be challenging, but it is essential for starting the healing process.
Therapy and Counseling
Therapy and counseling are core components of substance abuse treatment. They help clients understand the root causes of their addiction, develop coping strategies, and build a support system. Different types of therapy, such as individual therapy, group therapy, and family therapy, are often used.
Aftercare
Recovery doesn’t end when the initial treatment is over. Aftercare services, such as intensive outpatient, ongoing counseling, support groups, and relapse prevention programs, are vital for maintaining sobriety. BCBS coverage can extend to these services, ensuring clients have the support they need even after they leave our facility.
Why Longer Treatment is Better for Recovery
According to a study the longer treatment durations are the better the outcomes will be. Here are some reasons why spending more time in a program is beneficial:
- Deeper Healing: Addiction often involves deep-seated emotional and psychological issues. Longer treatment allows clients to address these issues more thoroughly with trusted, credentialed, and professional staff.
- Skill Development: Long term Recovery involves learning new skills and coping mechanisms. A longer stay provides more time to practice and reinforce these skills.
- Relapse Prevention: Longer treatment includes extended time for relapse prevention training. Clients learn to identify triggers and develop strategies to avoid relapse in the future.
- Stronger Support Network: Building a strong support network is crucial for long-term recovery. Extended treatment allows clients to form life long meaningful connections with peers and staff.
- Stabilized Lifestyle Changes: Lasting recovery requires significant lifestyle changes. Longer treatment helps clients stabilize these changes and integrate them into their daily lives.
How to Get Started
If you or a loved one is struggling with substance abuse and you have a BCBS Insurance Policy, don’t hesitate to reach out to Asheville Recovery Center. Here’s how to get started:
- Contact Us: Call our admissions team to discuss your situation and insurance coverage. We will guide you through the initial steps and answer any questions you have.
- Assessment: We will conduct a thorough assessment to understand your needs and develop a personalized treatment plan.
- Preauthorization: Our Utilization Review Department will handle the preauthorization process with BCBS, ensuring all necessary documentation is submitted.
- Begin Treatment: Once preauthorization is approved, you can begin your treatment at Asheville Recovery Center. Our team will support you every step of the way.
Conclusion
Getting substance abuse treatment covered by BCBS can be challenging, but at Asheville Recovery Center, we have the expertise and determination to make it happen. Our Utilization Review Department is dedicated to securing the necessary treatment time for each client, ensuring they receive the care they need to heal. If you or a loved one needs help, contact us today and take the first step towards recovery.
For more information, visit our website or call our admissions team. We are here to help you navigate the path to recovery with BCBS coverage.
FAQs
Q: What types of substance abuse treatment does BCBS cover?
A: BCBS covers a range of substance abuse treatments, including detoxification, inpatient rehab, outpatient rehab, therapy, counseling, and aftercare services. Coverage can vary based on your specific plan.
Q: How do I know if my BCBS plan covers substance abuse treatment?
A: You can contact your BCBS provider directly or reach out to our admissions team at Asheville Recovery Center. We can help you understand your coverage and guide you through the process.
Q: What if my preauthorization request is denied?
A: If your preauthorization request is denied, our Utilization Review Department will file an appeal and advocate on your behalf. We are committed to securing the coverage you need.
Q: How long does the preauthorization process take?
A: The preauthorization process can vary in length, but our team works efficiently to submit all necessary documentation and follow up with BCBS to speed up the process.
Q: Can I still receive treatment if I don’t have insurance coverage?
A: Yes, we offer various payment options and can discuss alternative funding solutions to ensure you receive the treatment you need. Contact our admissions team for more information.
