Insurance and Payment
What to Expect When You Call
Our goal is to make the administrative aspects of going to treatment as seamless as possible. We will work with you to determine your best options. Whether you are privately paying or utilizing regular insurance benefits, we are dedicated to finding affordable treatment solutions and work with most insurance providers, both in-network and out-of-network, to determine what is covered by your policy.
- We treat addiction, eating disorders and mental health disorders.
- Call 616.202.3326
- One of our caring Admissions Specialists will answer. If you just have questions, ask us.
- Have demographic, substance use/eating disorder/mental health, psychiatric and physical medical history information ready.
- Provide your insurance information .
- A Sanford admissions team member will assist with verifying your insurance benefits and talk you through your coverage and out of pocket costs.
- An admissions team member will guide you or your loved one through the admissions process and will help you determine the appropriate level of care needed after we learn more about you.
We work with the following insurance companies and more: Aetna, ASR health benefits, Beacon Health Options, Blue Cross Blue Shield, Blue Care Network, Cigna, Cofinity, First Health, Health Alliance Plan (HAP), Humana, Magellan Health Services, McLaren, Molina, Physicians Health Plan, Priority, United Health Care.
Often when people call, they are overwhelmed; they are calling on what might be a very bad day. But every person who calls Sanford Behavioral Health will know they are no longer alone. We are here to listen and help. Similarly, our team of admissions professionals works with your insurance providers. They will verify the benefits available to you under your policy. We can also assist you in identifying financing options. We do not want the process of paying for your stay at Sanford Behavioral Health to be a difficult experience. It is important to view addiction, eating disorder, and mental health treatment as an investment in your future.
When you call us, our admissions team is available to listen and offer an empathetic ear – even if you are just researching options. Our admissions team represents the first line of care you will receive at Sanford. They begin the process by gathering information and explaining our programs. This will help you and your loved ones understand your options. And it will help us determine your best level of care.
If you are calling for a loved one, we gather as much information as we can from you. And at that time, we will also conduct a pre-screening to determine medical and detoxification requirements and the timing and schedule for arrival into a Sanford program. The schedule is dependent upon availability of beds in our Detox and Residential Programs and space in our Outpatient and Virtual Programs.
Insurance coverage is a complex and changeable system, so it is valuable to have someone experienced work on your behalf. Sanford provides a turnkey solution to your needs – including helping you find another treatment center if a stay at Sanford is not appropriate.
The Sanford Admissions Team
The Sanford admissions team is here to answer questions and provide information about all of our programs. During your first text, email or phone call, we begin to build a medical record and get to know you better. The team works together to determine what is going to be needed and to map-out all the options for individuals who are seeking help, or for their loved ones or professional referent. Every conversation is unique. The team is ready to crisis manage, overcome barriers and provide voices of reason. And because they work together with other members of the admissions team, medical, clinical, and administrative staff, it assures our patients and their loved ones that they will receive a coordinated effort.
We are going to ask a lot of questions initially, and be prepared for those questions, because we'll want to know where you'll best fit on our continuum of care. Our goal is to put you in the least restrictive level of care possible that's going to help you the most.Alec Green, Managing Director Sanford Behavioral Health
Green Castle Health
Health insurance is complicated, and the payment models relating to behavioral health are evolving. Establishing, managing and protecting commercial insurance relationships involves advanced knowledge and expertise. Sanford has transferred these resources with the introduction of Green Castle Health (GCH): our in-house insurance billing company established to service existing and new programs. The Sanford executive team works closely with GCH to design, credential, implement, and manage new and existing payor relationships and models.
While ever evolving, traditional commercial insurance is divided between in-network and out-of-network models. The in-network model requires a contractual relationship between Sanford and the insurance company; this results in a lower negotiated fee structure but with a higher and more consistent patient census. The out-of-network model, the patient is permitted to identify and select a not-contracted provider. This results in lower patient volume but with a higher fee for services.
At Sanford we are committed to the in-network model when possible and this has become the direction of many insurance companies nationally as well. Today Sanford has 15 in-network insurance contracts and many initiatives in the works through Green Castle Health.
What is the Cost of Treatment?
A clinical assessment is completed to determine the type and level of care needed, and our admissions team will work with you and your insurance provider to determine costs covered by insurance as well as costs that are your responsibility.
Treatment does have a financial cost. But try to think about the cost from another perspective. What is the price of avoiding needed treatment?
- The actual cost of drugs and/or alcohol
- Expense of repeated visits to treatment that does not address all your conditions
- Medical costs such as ER visits and hospital stays
- Cost of legal help
- Lost wages from time away from work do to illness or intoxication, or losing your job
- The loss of relationships and interests.
What to Expect When You Arrive at a Sanford Facility
When you arrive at a Sanford Behavioral Health facility, you will be met by an admissions counselor. They will explain the basic operations of the treatment center, give you a tour and assign your room and bed if appropriate. Your bags will be inspected, and you will be given a drug and alcohol screening. Afterwards, you will meet with a therapist for a biopsychosocial assessment. The therapist will determine the complete range of conditions you are experiencing and begin to establish your individualized program. The information you provide is confidential and always received without judgment.
You will be assigned your individual counselor within the first few days of treatment. Attention is given to matching the client and therapist, based on personality, mental health condition, age, co-occurring disorders and other defining characteristics.
Upon arrival at a Sanford Outpatient Program, you will also be met by a staff member who is familiar with the admissions process. That person will walk you through the facility and introduce you to your individual therapist. If you are entering a Sanford Virtual Program, you will typically “meet” your individual therapist and complete admissions by phone.
We work with most insurance providers, both in-network and out-of-network (Medicare/Medicaid does not participate with our program). Coverage may differ per treatment facility. If you have questions about one of our accepted insurance providers, or if you need more information on another insurance policy, financing, or Sanford program descriptions, call 616.202.3326.
We work with the following insurance companies and more: Aetna, ASR health benefits, Beacon Health Options, Blue Cross Blue Shield, BCN, Cigna, Cofinity, First Health, Health Alliance Plan (HAP), Humana, Magellan Health Services, McLaren, Molina, Physicians Health Plan, Priority, United Health Care.
We have chosen Excursions articles and outside resources to provide you with more information about insurance and treatment.
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