Category Archives: Substance Abuse Billing

Drug Rehabs Losing Business Marketing Focus

Drug rehabs during 2019 and for approximately the last five (5) years have been experiencing a trend which has been infecting the financial health and welfare of the addiction treatment industry. Dale Redlich, CEO of Pay2Patient and well respected past treatment center owner for over 20 years provides this article with his insight on some issues that owners are facing in our industry with this article.

A Snapshot of the business and Drug Rehabs Marketing Side

Drug rehabs have been experiencing a trend that has manifested itself in recent years with;

  • downsizing
  • bankruptcies
  • selling off of assets
  • staff firings
  • lack of staff replacement
  • lack of staff additions
  • lower staff salaries
  • changes in marketing techniques
  • development  of joint ventures with financially sound publically traded companies
  • mergers and acquisitions

In addition, there is a desperate attempt by many owners and operators of addiction treatment facilities (including the detoxification and lab segment) to develop new relationships. These include banking, investment, and other financial relationships which might result in an infusion of new capital into an otherwise unhealthy marketplace. Basically, inexperienced drug rehabs and operators where wasting financial resources in an attempt to “out do “ their competitors. They are trying to offer more and more luxury within their drug rehabs. They are attempting to compete for a very limited supply of high paying clients

This trend has and will continue to affect not only full-service outpatient, PHP, inpatient, and residential addiction treatment centers West Palm Beach and across the nation, but also all of the ancillary support businesses including, sober living facilities, halfway houses, and private practice therapists as well as labs.

Drug Rehabs Pain Points

The signs have been evident for a substantial time period, but the problem has been and will continue to grow more severe as time continues. The main pain points of drug rehabs are marketing and billing. These are the two hands that are feeding any addiction treatment center.

Many centers have poor drug rehab SEO that is costing them big dollars in the wasted marketing budget. The second biggest pain point is the abundance of money left on the table from substance abuse billing and utilization review. The biggest concern is that some owners think they have this under control. The reasons for this trend varies but in general, it can be seen as being attributable to a number of predictable factors such as;

  • poor marketing strategies and  drug rehab SEO solutions
  • a severely growing level of competition for the same patients
  • lack of education on the web marketing and search engine optimization
  • changes in the number of payments made for treatment by the insurance industry
  • new and far-reaching legislation which has severely limited the ability of such facilities to engage in traditional marketing
  • a lack of sufficient capital from an operational standpoint
  • rapid and unnecessary expansion
  • an attempt to offer only the most high priced luxury

It may also be seen as a failure of the new wave of financially inexperienced and undercapitalized drug rehabs and opiate detox West Palm Beach centers who have been unable to foresee such trends and also have miscalculated the effects of massive changes occurring in the insurance marketplace both for in-network and out of network providers.

Insurance Companies Controlling the Drug Rehabs

One area which evidences this trend in the insurance industry. It is the growing direction for providers to attempt to change from out of network to full in-network providers. Most facilities these days are desperately becoming only in-network providers even though the amount per day paid by the carriers for in-network benefits has steadily been falling.

No longer do the carriers have to devise methods to try to force drug rehabs to become in-network.  It was only a few short years ago when the carriers were paying exorbitant amounts per day to out of network providers and the thought process of owners at that time was to remain out of network in order to reap the benefits of the absurd amounts of money which the carriers were paying for out of network benefits.  This could not continue forever.

When Insurance Companies Send Payment Directly to Clients

In fact, there are some insurance carriers such as Federal Blue Cross and Empire in Florida which continued to pay large unsustainable amounts directly to centers clients. The carriers continue to issue their reimbursement checks directly to the patient or subscriber. This results in many cases with the insurance checks being cashed by the patient. Thus the drug rehabilitation center is out of their earned money. If you are in this situation you can contact Dale Redlich, CEO of Pay 2 Patient at 954-592-1921. They specialize in collecting from insurers that pay the patient directly.

Understanding Drug Rehabilitation Centers Money Owed

Obviously, this was and continues to damage the providers financially. They are rendering services in good faith but never receiving the checks from the carriers.  The reality is that many providers did not even realize that their check-in reimbursement for services rendered had not even been sent to them by the carrier. Some of the providers are losing exorbitant amounts of money in this fashion. Many do not realize this when it is happening.

The result of all of the above circumstances is that the drug rehabs have split into the “have’s” and “have-nots”.  If you attend industry events you will likely realize that not only have the attendance numbers plummeted but the actual exhibitors themselves. They are often comprised only of the larger most well funded (and often time owned by publically traded companies). Many centers are looking for smaller, focused events that also provide business and drug rehab leads education to survive the competitive landscape. In addition, they need to implement strategies of how to properly prepare for these addiction conferences.

Allocating Drug Rehab Marketing Drug Rehab Marketing Dollars

It is unbelievably expensive for a facility to finance large numbers of their marketing staff to attend these events. Many are only marketing to other marketing staff from other facilities. This is financial lunacy, without getting educated on proven business and marketing strategies. Unless the provider has extremely deep pockets which some of them still do.

The savviest operators realize that the money spent on traditional marketing and attendance at events that do not provide proven business and drug rehab marketing practices. The money spent is much better utilized with drug rehabs leads, social media and other types of online selling of their services. One of the biggest mistakes they make is using boots on the ground as their main marketing strategy. Without a robust, healthy and planned marketing mix, many are at great risk of closing their doors.

Getting Control Over Debt Collection and Revenue Cycle Management

Substance abuse billing and revenue cycle management are critical areas for owners. So, where does this leave us? The purpose of this article is to educate drug rehabs on the vast amount of lost revenue that is left on the table. The key areas that need to be addressed are; billing,  utilization review, and drug rehab SEO marketing.

However, at the same time that are certain methods which at almost no cost can result in the infusion of additional capital into a sagging P/L statement. Substance abuse billing and debt collection with revenue cycle management for drug rehabs is one potential partial solution to the financial problems being experienced in the healthcare industry and in particular, the addiction treatment industry.

The collection of a debt is a financial strategy which has been around since the time of the money lenders in biblical times. If a company lends money, or advanced money or fails to receive legitimate funds on component aspects of its business it should be entitled to take appropriate action steps to recover the resulting debt if such debt is attributable to the loan or advancement of funds to the potential debtor. There is nothing immoral about a company taking steps to collect its fair debt, In fact, it is business malpractice not to go after the fair debt which is owed.

What is Drug Rehab Revenue Cycle Management?

Revenue Cycle Management is a fancy way of describing the method of tracking accounts receivables.  Utilizing such funds at the appropriate time to pay the operational internal debt on an ongoing and predictable basis is critical. Substance abuse billing and revenue cycle management are two key areas centers to look at closely. Drug rehabs are leaving 20-30% of their revenue on the table. Treatment centers need to evaluate their substance abuse billing every year. It is advantages to bring 2-3 billing providers every year.

Evaluating several different substance abuse billing and utilization companies will ensure there is no money left on the table. The insurance companies are playing games with reimbursements, and these companies on the front line. Many billing companies will get lazy after the low hanging fruit is gone. There are many drug rehabs that are owed big dollars. Not knowing how to code is only one of the issues causing this problem. This is one of the biggest areas causing centers to close across the nation. This is one of the topics we are covering in our upcoming addiction conferences EMP Series event on 1/22/19.

Reclaiming Precious Drug Rehabs Operating Capital

The problem experienced by the addiction treatment industry now in many cases is that the provider company has not taken sufficient steps to ensure that it has sufficient operating capital. The money gets spent in a variety of other ways as described above. And oftentimes there are is no margin of error for drug rehabs which results in layoffs and other dire consequences.

It defies our understanding of why a health care provider which is owed money would not take every reasonable and legal action to collect money which it is owed. It seems to be lunacy but at the least very bad business practice.

Reclaiming Drug Rehabs Receivables Doesn’t Cost Much

The ROI to employ debt collection methods is so low as to beg for utilization. The process is very simple for drug rehabs, but at the same time there are Federal and State regulations which must be complied with and of course, the privacy of the patient/debtor needs to be protected. This can all be accomplished by utilization of the proper documentation.

Don’t get me wrong. It is not easy to collect the debt. Collections methods vary depending upon the type of debt, the age of the debt, the identity and location of the debtor, Federal and State Law, peculiarities of the court system, and other factors but the fact remains that the collection of debt can be “found’ money and help immensely in providing additional and needed revenue to the provider  to help with the covering of operational expenses. All addiction treatment centers should have a third party look at their substance abuse billing and utilization review. This will uncover a tremendous about of lost revenue.

Drug Rehabs Regaining Business Focus to Survive a New Industry

There is nothing dirty, or unseemly or embarrassing about drug rehabs taking every step possible to recover money which it is owed. After, all don ‘t companies which the provider owes money to try to collect such funds? And, if you’re worried about upsetting the debtor then think about the fact that your employees expect to be paid every week and in my own humble opinion those individuals are a lot more significant than the person who owes your facility money.

Whether you are after co-pays, deductibles, self-pay fees still owed,  insurance checks which were sent to the patient, client loans, or other debt your company is entitled to take all lawful means to collect this money.  Drug rehabs not only need to look at their collectibles, but also their substance abuse billing providers. This is one of the main reason centers are closing. The insurance companies are playing games with reimbursements.

Addiction Conferences Educating Drug Rehabs Losing Business Marketing Focus

Operating drug rehabs is a difficult task. Operators of substance abuse treatment centers need ongoing education on the business and drug rehabs leads marketing side of behavioral health. New laws, regulations and knowing how the insurance companies are operating is paramount. Marketing, substance abuse billing and utilization review mean big money for drug rehabilitation centers. Evaluating these regularly will produce large checks of operating cash. The addiction EMP (ethical marketing practices) conference series addresses these issues.

BHNR has brought 14 successful addiction conferences to South Florida. These talk show host/town hall-style conferences provided proven business and marketing strategies to operators during the regulation of our industry in Florida. We are proud of these national addiction conferences. Please check out these addiction conferences EMP Series events.

Top 3 Benefits of Drug Rehab Consultants

Drug rehab consultants play a vital role in the addiction treatment industry. Whether you are a new start-up, an existing center, or an ancillary service provider you need consultants for various reasons. Behavioral health business and marketing consultants prevent costly mistakes, save revenue and increase return on investment. Drug and alcohol addiction treatment centers and the entire industry spend a lot of money on their drug rehab marketing strategies. Without the expertise of a consultant they can, and do, waste hundreds of thousands of dollars.

Why Drug Rehab Consultants?

As an addiction treatment center owner, you’ve spent an enormous amount of time and resources to have a structurally sound clinical component for your center. You’ve hired the best and most qualified clinical team and have the best clinical protocols in place. The treatment side is usually the owner’s specialty. Many centers will hire accreditation consultants for their Joint Commission (JACHO) and Commission on Accreditation of Rehabilitation Facilities, (CARF.)

These accreditations are extremely important for the treatment centers allowing them for better overall treatment for their clients, assists in gaining clients and makes them authority over their competition. Consultants charge $30,000 or more to get them through the accreditation processes. Drug and alcohol addiction treatment centers owners know that these are an absolute necessity for their behavioral health organizations. The second reason drug rehab owners hire consultants is that at some point they all realize the importance of marketing. Then, they quickly realize they are competing against big dollars being spent by the larger addiction treatment centers every month. They also start to realize they need an internet of things (IoT) electronic footprint driving targeted traffic to their website for their addiction treatment center marketing.

Drug Rehab Consultants Save Money

Many owners do not put the same time, resources and investment in their marketing. Many do not respect marketing, nor do they understand the time, education and resources for an effective marketing strategy. They generally take short-cuts with their website, SEO and overall marketing. These short-cuts are saving pennies and wasting dollars in the long run. For example, they might save a couple of thousand dollars on their website build.

Their website looks beautiful to the eye, however, it usually has poor structure, no schema, poor Google My Business and an extreme lack of social media marketing. Drug rehab centers must have a robust and targeted drug rehab marketing mix to survive the business and operational changes in our industry. Drug rehab consultants provide the experience and knowledge to avoid costly mistakes on the business and marketing side of our unique industry.

Drug Rehab Marketing Consultants Should be Part of the Package

All drug rehab consultants should be assessing the most important aspect of addiction center treatment marketing. Contrary to what most addiction treatment center owners and ancillary service providers believe your website is the most valuable asset in generating leads. There are 7 key mistakes made with website development made by addiction treatment centers when generating drug rehab leads. Set-up correctly it will outperform all other marketing aspects combined. If set-up poorly you will be wasting a ton of marketing dollars and blaming your drug rehab marketing agency for poor results. You will be forced to using “black hat” marketing strategies and continuously get penalized by Google. This is where drug rehab consultants play a vital role in the success of drug and alcohol addiction treatment centers.

Long-term Marketing Strategy Needed

Here is where CEO’s and Executives need to have a long-term marketing strategy in place. Your addiction treatment center or any business website works 24 hours a day, 7 days a week. This employee never takes a day off, never goes on vacation and you don’t have to pay for its benefits. Best of all as a treatment center owner you have 100% control and know if you set something it will happen 100% of the time.

This can work for you or against you. The question is how you fine tune this engine to work efficiently. First, you must understand that what you see on the screen when you are visiting a website is only 10%. The other 90% is back-end stuff that must sync perfectly to get blessed by the Google GODS.

Your Website Must be an Authority and Trusted by Google and Potential Clients

Why is it vital for addiction treatment centers, or detox’s staff to be published on high profile industry websites? This positions them as an expert in drug and alcohol addiction treatment. Citing and including them in your websites builds instant trust with potential clients. Also, getting published on other high authority websites increases Google ranking. One of the most difficult areas of drug rehab SEO for addiction treatment centers and ancillary service providers is getting those back-links pointing to their websites.

Regardless of whether your clinicians don’t have all the flashy letters after their names, it is still greatly supportive if they compose articles and blog entries on your website. It is likewise similarly as critical or much more imperative for drug and alcohol addiction treatment centers to distribute video recordings of staff teaching people in general about drug addiction and recovery. Videos rank the highest on Google and social media for retention and they help build trust. In fact, they receive more than 60% of the click-throughs. Behavioral Health Network Resources offers drug rehab SEO marketing and training to get your center on page one of Google.

Drug and Alcohol Addiction Treatment Marketing Best Practices

Spread out your drug and alcohol addiction treatment center marketing budget. Putting all your marketing dollars into one bucket like AdWords spells disaster. Many learned this mistake when Google restricted paid ads, some did not make the learning curve and had to close their doors. The centers that survived had good drug rehab consultants which put into place a diverse marketing strategy. Categorize your marketing into three buckets. This way when one bucket isn’t working you have the other two generating phone calls. Even with three buckets going on at the same time one, two or all three could fail at any given time. The three main buckets should be organic, boots on the ground and a paid advertising strategy.

What is organic marketing and Drug Rehab SEO?

Organic marketing in one of the most difficult for drug and alcohol addiction treatment centers and ancillary service providers to fully understand. It starts with proper website structure. Without proper website structure, your website is going to be leaking Google ranking juice. Google with either not read the site or penalize it. This is where most marketing dollars are wasted by many treatment centers.

After structure, you need to look at search engine optimization (SEO.) SEO is a complicated process and impossible to know all there is to know on the subject. Even the best drug rehab consultants only know a fraction of SEO. However, they do know the many best practices that can get you to the first page of Google. Google only reveals a few golden nuggets; the rest is best practices. We get 10-15 calls every week from drug and alcohol addiction treatment centers on marketing and consulting. Almost everyone says their on-page SEO is good. This is rarely the case. I always ask them if they have Yoast installed on their website. Yoast is a WordPress plugin that tells you and guides you in having decent SEO on your site. Yoast will tell you if your SEO is at an acceptable level. Once things are up to par with Yoast, it is time to hire an SEO specialist.

Organic SEO also covers publishing useful, attracting and engaging content. It is not enough to have you site look good in Google eyes, it also must be useful to the reader.

Understanding Social Media Marketing

The last part of organic SEO is social media and this is an absolute must. According to Tech Crunch, people are spending over 5 hours a day on their cell phones. This doesn’t include time spent on PC’s at work and home. Our society has been consumed with social media being a daily part of our lives. It is paramount that your addiction recovery center gets in front of potential clients daily. For the most part, this is not a features and benefits sales pitch. It is attracting and engaging potential clients with good content on an emotional level. Then attaching that emotion to your brand. You must build trust by providing content that conveys you understand the trials and tribulations they are experiencing with addiction and can help them.

Even with great content, it is useless unless you have the vehicle to get in front of the potential masses. It takes an intimate understanding of Facebook and LinkedIn. Addiction treatment centers must understand the secrets, tricks, and back-doors of these mediums to maximize their potential to drive leads. Facebook announced its new algorithm that puts the power of business marketing with individual profiles and groups unless you pay for the advertising.

We have been preparing for this social media marketing shift for the last four years. We are one of the few marketing companies that practices what they preach when it comes to marketing on Facebook and LinkedIn. We have built up 30,000 level one connection’s on LinkedIn and 12 groups with over 50,000 members. On Facebook, we have 15,000 friends and 35 groups with over 150,000 members.

Boots on the Ground Pitfalls

Almost every addiction treatment center puts most of their marketing efforts in boots on the ground tactics. While it should be in every drug and alcohol addiction treatment centers marketing mix, it should only be a portion of the marketing mix. All drug rehab consultants should be telling you to have diversity in your drug rehab lead generation. We see many centers using boots on the ground, Google AdWords and call center lead generation.

This is most likely due to the CEO’s and Executives looking for short-term solutions to keep their census at an acceptable level. They tend to get caught up with hiring Outreach professionals that say they have a book of business. This strategy has caused an extremely high turnover rate in the addiction treatment industry. Outreach professional’s positions usually last from 6 months to a year. We see this by looking at out 30,000 addiction and behavioral health professional level one connections profiles on LinkedIn. Many owners do not realize that this situation actually costs the drug rehab centers about $20,000 per turn over.

Paid Advertising the King of Short-term Solution to a Long-Term Problem

Google AdWords or pay per click (PPC) has paved the road for unprepared drug rehab marketing plans. Addiction treatment centers have notoriously used AdWords in place of a good organic marketing plan. This is mind-boggling considering the paid AdWords account for less than 5% of the click-throughs on Google. The first three organic slots account for a whopping 70%. Bing, Yahoo, and MSN are comparable to these numbers.

Google AdWords restrictions are somewhat being lifted in July of 2018. While we will see some centers jumping back on that merry-go-round, some should have learned the value of organic marketing. This is a long-term play that once established can last for years and generates higher converting clients.

Buy Rehab Leads is a Short-term Solution

Another famous short-term solution is a buy rehab leads strategy. Many treatment centers complain about buying calls but continue to do so. Now, in Florida, they are no longer allowed by law to buy verification of benefits (VOB) calls. This call center leads generation option would give treatment centers qualified leads at least guaranteeing that the potential client has the insurance the center offers.

These drug rehab SEO marketing buckets are constantly changing and providing different leads at different times. At any given time, they stop producing leads, and not for any given reason. As a CEO or Marketing Director, you need to be juggling all three constantly. One of the biggest mistakes that drug rehabs make is when the census is up they do not invest more in their drug rehab marketing efforts.

Measuring the Success of Each Drug Rehab Marketing Bucket

Drug rehab consultants should be putting in back-end analytics to measure efficiency. Keeping in mind the end goal is to understand your most elevated ROI. It is imperative to track lead generation sources that are converting into clients. It is critical to gauge the “first contact” when the individual seeking addiction treatment reached out.

  • Did they call?
  • How many calls?
  • What blog post generated the call or click?
  • Did they click through from a landing page?
  • Did they click through from Google, Bing, Yahoo or MSN?
  • Did they click through from Google Maps?
  • Was it from a “boots on the ground” lead?

This is vital for marketing intelligence. By knowing this information, you can adjust your marketing strategy and fuel resources to what is working at that time. Again, this is not stagnant, it is constantly changing and adjusting is critical.

Call Tracking Metrics an Inexpensive Absolute Must Have Tool

The key to maximizing your ROI on marketing dollars is to know what is generating the most drug rehab leads, or calls. Call tracking can tell you where the potential client started and right through to where they called from. This is vital information for the marketing team. You can also assign a dollar value to the services sold to have dollars associated with conversions. It will also record the calls, so you can determine if admissions teams are doing a good job of converting clients. It also gives information on date, time, city, state, and much more. You can check out how this inexpensive valuable drug rehab call tracking tool is for your center.

Why Add Google Analytics to Your Drug Rehab Marketing Plan?

Google analytics like call tracking provides information on addiction treatment centers websites. All drug rehab consultants should know how to read and utilize this vital information. It tells you real-time traffic, city, state, pages visited, where they came from, interests and more.

Google analytics tells you what the most popular pages of your website and blog are. It tells you how long they stayed on your website. If it is less than 60 seconds, it is called a bounce. If you have pages with a high bounce rate, then you need to edit those pages to make them more engaging. For the pages with long visit time, it tells you that it is good content and you should be producing more similar content.

Providing Staff Tools for Effective Drug Rehab Marketing

Without experienced, educated and dedicated workers, it can be a battle to become a successful behavioral health organization. This is especially true when hiring drug rehab consultants. In addition, because we are in a video age on social media, you need staff to speak and present about your drug addiction treatment program in front of a camera. They must be able to convey treatment information and touch on an emotional level. This is a human aspect that will build trust and position your drug and alcohol addiction treatment center as an authority. Building electronic video assets is critical for getting clients and getting to page one on Google.

The Role of Addiction Conferences and Events

Conferences, events and training’s play a vital role in our industry. You should be sending your staff to events and conferences to build on their knowledge of treatment, marketing and the business side of behavioral health. Many drug rehab consultants attend many of these events to gain much-needed knowledge of our complex industry. You need to provide tools on an on-going basis and not just hiring them and relying on their book of business. Getting them educated on the business and marketing side of our industry. You can check out our next behavioral health conference on.8/6/19 and get involved.

CEO’s, Directors and Outreach need more education on marketing, social media (so their not damaging your brand,) networking strategies, SEO, call tracking, Google analytics, patient brokering, billing, collections, utilization review and many more. Providing them ongoing education and experience will pay dividends down the road.

Behavioral Health Network Resources provides 3-4 addiction conferences every year. These conferences feature Executive Thought Leaders, drug rehab consultants, Senators, Attorneys and high profiled and experienced behavioral health professionals. Each conference attracts 5-7 Addiction Executive Thought Leaders, 150-200 attendees, and 14-20 exhibitors. We are seeking co-host sponsors for our next Florida and California conferences. Contact Charles Davis at 561-235-6195 and get national exposure.

The Importance of Offering a Full Continuum of Care

When you go to a restaurant they don’t force you to order a few items. They generally offer a la carte. You need to offer the most options possible that relate to drug and alcohol addiction treatment. You are investing a tremendous amount of time, resources and money in your addiction treatment marketing strategy, you need to make sure you have a lot to offer when they decide to pick up the phone.

  • 30, 60 and 90 In-patient Partial Hospitalization Program (PHP)
  • Out-patient treatment Intensive Outpatient Program (IOP)
  • Alcohol and Opiate Detox
  • Medication Assisted Treatment (MAT)
  • Christian Track
  • LBGTQ Track
  • Sober Living Options
  • Aftercare
  • Telehealth
  • Family Program
  • And many more

Two of the best motivations to do this is the insurance companies are demanding documented improvement of clients. Second, it costs a considerable amount of cash to produce qualified drug rehab leads and you need to maximize revenue.

Consultants Assist on the Business Side of Behavioral Health

The two main areas for addiction treatment centers to gain revenue include marketing and billing. We’ve covered some marketing aspects above, however, there are other areas to consider. Billing and collections can get out of hand very quickly.

The insurance companies are playing dirty by rejecting claims, delaying reimbursements, questioning medical necessity and auditing addiction treatment centers to get out of paying for services. We recently sat down with Scott Delmarr, of Proven billing, a respected behavioral health substance abuse billing and utilization review consultant. Here’s what he had to say.

One of the most difficult areas is collecting from the insurance companies. Receivables get out of control quickly and drastically effect operating cash flow.

To make it even worse there are some situations where the insurance companies send the checks directly to the treatment centers clients. This causes huge problems for treatment centers and detox’s to get those checks.

Many times the treatment center’s clients keep that money. How bad is this situation, some centers can have millions of dollars in receivables from this situation? These are evident especially with Empire and Federal BCBS insurance in Florida. You can contact Mr. Redlich at 954-592-1921 with any questions.

So, Why Hire Drug Rehab Consultants

As an owner of an addiction treatment center, detox, or ancillary service provider, you are going to spend on the low-end hundreds of thousands of dollars on your marketing. Drug rehab consultants can put a proven marketing plan in place producing the best ROI and reduce waste. Consultants can tell you what works and what does not work. They can tell you how to get your website built with proper structure.

They can tell if drug rehab SEO is poor and put a team in place to correct it. They can put into place and train marketing staff on call tracking and Google analytics. They can train your admissions staff to maximize your call center lead generation. Drug rehab marketing consultants are proven and trained guides that completely understand the business and marketing aspects in the addiction treatment industry.

Behavioral Health Network Resources are drug rehab consultants, drug and alcohol addiction treatment marketing specialists and we also host addiction executive conferences education on ethical business and marketing strategies. In addition, we partner with the nation’s best JACHO and CARF accreditation consultants, Give us a call for a no-obligation consultation today at 561-235-6195.

Call 561-235-6195 Ask About Our 4-Week Consulting Package 

Substance Abuse Billing #1 Costly Mistake

The Critical Role of Substance Abuse Billing

Substance abuse billing is a complicated process and mistakes can be costly. Drug and alcohol addiction treatment centers are constantly battling insurance companies for reimbursements. Billing consultants and third-party billing companies can be beneficial to maximize results and get payments quickly. Health insurance claims for substance abuse are often delayed by the health insurance provider. Many behavioral health providers account receivables get out of control very quickly. It is a constant struggle for addiction treatment centers and detox facilities. If this isn’t difficult enough, some insurance companies send payment directly to the patient.

Substance Abuse Billing; Is Getting Paid in 14-Days with Revenue Cycle Management Possible?

From drug rehabs Los Angeles to New Jersey getting paid in behavioral health care is a daunting task for many providers and billing companies. Billing companies usually take the low hanging fruit from common mistakes made by recovery centers in-house billing or the previous billing companies mistakes. After this, this real work of recapturing lost revenue or getting paid quickly is a difficult task.

Not having sufficient operating cash is a common problem for many rehabilitation centers. Some rely on billing companies and trust they are doing a good job. Some do their own in-house billing. Either way, in-depth knowledge is an absolute must to get paid quickly. So, what are the common mistakes made by addiction treatment centers? We took this question to Jim Woods, VP of Advanced Data Systems Corp, an industry leading substance abuse billing company. Here is what he had to say.

Many treatment centers could save large amounts in their billing by outsourcing. With proper guidence they could get better reinbursments by doing the behavioral health billing in-house. Many are unaware and need to look closly to recature operating cash.

Completely understanding the insurance companies and establishing relationships is the key to getting paid. substance abuse billing is a key area for many centers to address. We found this so important, that we invited Advance Data Systems Corp and two other billing related organization to be panelists at our next addiction conference.

Addiction Conference Educates on Business and Marketing Pain Points

You can learn more about increasing your cash flow, proven business, and marketing strategies at the Addiction Conference EMP Series and Professionals of the Year event.  This addiction conference features 8 national thought leaders providing strategies in substance abuse billing, drug rehab SEO, website development, ethical business and marketing and tools to thrive with the new marketing laws.

Insurance Companies Are Bullying Behavioral Health Providers

Addiction treatment centers, opiate detox’s and third-party substance abuse billing companies work hard on efficient billing, billing procedures and utilization review. One mistake could cost upwards of $30,000. Obtaining the knowledge to prevent these costly mistakes is paramount. Behavioral health organizations can generate revenue in three different ways. They must play critical attention to their billing, collections, and drug rehab marketing strategies.

Insurance companies are bullying substance abuse and mental health providers. They are denying substance abuse billing claims, delaying reimbursements, questioning the medical necessity and auditing these organizations. These tactics cause severe problems for providers. The insurance companies for the treatment of behavioral health care issues are using these strategies mainly due to the Affordable Care Act. It has made health insurance available to many by providing subsidies towards the cost of health care for many individuals. It requires insurance plans to cover pre-existing health conditions and much needed mental health and substance abuse treatment. However, the addiction treatment providers are battling high deductibles and insurance company tactics that reduce what they pay out in reimbursements.

The drug and alcohol addiction treatment providers are constantly fighting Goliath to get their substance abuse billing reimbursements for services provided. Insurance providers are constantly seeking ways to cut monies they have to pay out. The insurance companies are also battling fraudulent healthcare providers submitting inflated clinical documentation, services not provided and excessive services. This has caused severe problems for ethical operators. They have to be faster and stronger to keep up with the changes occurring in behavioral healthcare.

Substance Abuse Billing and Collections

Substance abuse billing vs. utilization review is the first step in recovery centers getting paid. Outstanding receivables are generally extremely high for addiction treatment centers and detox facilities. Many times their in-house billing or third-party billing providers don’t address receivables past 90 days very well. In some of these cases, they lack the knowledge and time resources to obtain these lost funds. Addiction treatment centers and detox providers should constantly be reevaluating their providers and seeking new providers to recoup these dollars. Reevaluating all their ancillary service providers is critical due to the current state of our industry.

Pay 2 Patient Collections

We also recently sat down with Dale Redlich, Co-founder of Pay 2 Patient LLC, to investigate other costly billing issues that centers face. We found that some substance abuse providers have millions of dollars in uncollected claims. This situation arises due to lack of knowledge of some insurance policies and proven strategies to obtain the insurance payment. This is what he had to say.

Treatment providers often start treating clients are unaware of how much the insurance companies will pay. Even with their experience sometimes the payment for services is sent from the insurance company directly to their client. Usually by the time the treatment providers realizes this, it is too late. They have no idea on how to effectively get this payment and generally never do.

Pitfalls When the Insurance Company Pays Your Client Directly

To begin with, Out of Network (OON) claims are usually more costly to the insurance carrier and to the patient. As a mechanism to encourage participation in its network (certain laws mandate this to happen) in network carriers will issue payment directly to the provider on behalf of the patient.  However, some carriers do not extend this outcome to non-participating or OON providers.

Rather than pay the non-participating provider directly some carriers (Empire and Federal BCBS in Florida) issue payment directly to the patient.; the reimbursement check is made payable to the patient not to the service provider.  This can disrupt the provider’s cash flow and this creates the Pay 2 Patient circumstance. This usually occurs when the insured does not execute the assignment of benefits and attest to it.

Confused Behavioral Health Substance Abuse Billing Providers

Providers become understandably confused about how this could happen. Consider the provider’s substance abuse billing staff and admission staff has had the patient execute all the correct authorizations. They verified the assignment of benefit (AOB) at the time of admission. Most providers think that if all such documentation is executed by the patient that checks will be sent to their office. For many providers, the assignment from the patient is unlikely to be honored by the carrier and its check will be sent to the patient anyway. This comes as a surprise to many providers who expect to receive the check from the carrier so long as it has a valid attested assignment of benefits.

In many cases, both the patient and the provider’s staff are unaware that the insurance checks will be sent directly to the patient. This includes even when the patient had already given the provider an assignment of benefits. And, even when the staff is informed mistakes and oversights are often made. Sometimes, it is only during routine claim A/R review that the billing staff realizes that the check they have been waiting for has already been sent to the patient.  The carrier generally does not routinely inform the providers billing staff of this circumstance

Addiction Treatment Centers Can Have Millions in Receivables and Not Know It

This is when the problem becomes acute and financially damages the providers anticipated cash flow. This is because it’s extremely difficult for the provider to recover such insurance payments from the patient who has already received the check. Many times the client has cashed it and possibly spent the money.  Obviously, the practice of issuing checks directly to patients instead of the provider has greatly impacted the cash flow of many providers. Drug rehabs in Florida should make sure that the insured also executes an AOB and attests to it

Florida’s controlling law in this area is Florida Statute 627.638 in which it states;

  • Section (1) that an insurance contract “may” allow the carrier to send payment directly to the provider of services if such directive is contained within the policy using appropriate language and there is an attested authorization of benefits from the insured.
  • Section (2) of this law it is clear that the duty to pay the provider exists when the insured and not just the patient has signed the AOB and attested to it

Benefits of Insurance Companies to Pay the Client Directly

Providers have to remember that issuing checks directly to the patient serves an important benefit for the insurance carrier. Mainly due to this entire process might become a pressure point for more providers to join the carriers’ network. This eliminates the risk of not receiving reimbursement checks. Paying patients directly provides an important impetus for nonparticipating OON providers to join the network.

It is important to note that some states like NJ, TX, CO, NV, and others have enacted laws which protect the provider. these laws are in place whether such is in network or OON. A very few other States have also passed similar “mandatory assignment of benefits” laws which protect providers.  But, only a handful of States have passed such laws.  In such states, the law basically says that if an AOB is executed to their provider. They are subject to certain rules, the carrier must send payment to the provider, not the patient.

Properly Handling Empire and Federal BCBS Insurance Policies with substance abuse Billing

If a patient is admitted on an OON basis and the client has certain insurance such as Empire or BCBS Federal and the insured does not sign the AOB (assignment of benefits) there is a distinct possibility that when it comes time for payment of the providers fees the check from these carriers might go directly to the patient.

Of course, many providers in this circumstance do try to be prudent and educate them by informing them that the insured needs to sign the AOB. However, if the insurance check is sent directly to the patient their obligation is to immediately endorse the check to their provider in payment of the fees for service.  But, many clients who receive the insurance check after they are no longer in treatment keep the check and, cash it.  Some clients go to multiple treatment centers to try to play this game to the fullest extent.  This is the dangerous result of pay 2 patient.

Remember that in states like Florida when the provider has an assignment of benefits document. It’s in the file signed only by the patient there is no actual legal protection against the carrier paying the patient directly. Finally, when and if a third party reimbursement check is sent by the carrier directly to the patient most providers and billing companies lack the resources, time or expertise to “chase” the patient for a return of the insurance check.

Substance Abuse Billing #1 Costly Mistake Chasing the Reimbursement Check

There are many areas of substance abuse billing that behavioral health organizations overlook. Getting paid quickly is paramount for many providers. This is one of the main reasons we are seeing recovery centers close their doors. Re-evaluating your current sales and service drug rehab providers including your substance abuse billing company or carefully looking at your in-house billing could be the difference of keeping the doors open. Behavioral healthcare billing is a complicated process that demands great attention. Many drug rehabilitation centers think that this is under control and unknowingly have left huge chunks of operating cash on the table.