| We have gotten many phone calls from people who | | | | benefits available and the patient (or family member |
| have had a family member who was in an inpatient | | | | with the insurance) can get reimbursed. The problem is |
| drug and alcohol rehab facility that did not accept their | | | | that the facility does not submit the claims. They |
| insurance. Of course when the family member was | | | | usually provide the patient with a 'walk out' statement, |
| admitted it was a crisis situation, and there was little | | | | or some other form that shows the charges. |
| choice as to what options were available. In many | | | | The insurance companies usually require that the |
| cases it is actually life or death. They certainly can't be | | | | charges be submitted on a UB04 form, which is the |
| driving around looking for a participating facility. | | | | universal claim form for facility billing. It isn't that they |
| The problem is that these out of network facilities | | | | don't want to pay, but the information that they require |
| require payment for the services up front. Since they | | | | is not on the walk out statement that the facility has |
| do not participate with the insurance, they need to | | | | provided to the patient. The facilities don't know how |
| make sure they will be paid. The only real way for | | | | to complete these UB04 forms, and they've already |
| them to ensure payment is to get it in advance. Again, | | | | been paid. Many times they truly want to help the |
| due to the situation, the family has no choice so they | | | | patient get reimbursed but they simply don't know how. |
| borrow, or charge, or whatever they need to do at the | | | | If you find yourself in this situation, the first thing you |
| time. | | | | must do is to contact your insurance company and |
| A lot of times their insurance will have out of network | | | | find out if there are out of network benefits. |