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Owning a Drug Rehab: The Business Side

Owners are often not shown the appreciation they deserve for owning a drug rehab. These individuals are at the frontline of the opioid epidemic. They have dedicated their lives to saving lives and helping others achieve long-term sobriety. The general public does not realize how difficult it is to own and operate a drug and alcohol addiction treatment center.

Complex Process of Starting a Drug Rehab

Most substance abuse rehabilitation center owners and operators are in recovery themselves. They know firsthand how drug and alcohol addiction can destroy lives. Many strive to help as many people as possible, and this is not an easy task. As an owner of a substance abuse disorder treatment rehabilitation facility, many things must be taken care of daily and monthly to keep the doors open. There are very high costs associated with owning and operating a drug rehab. If these individuals cannot pay their monthly bills to keep the doors open, they cannot continue to help individuals into long-term recovery.

Starting an addiction treatment center is challenging, especially managing the licenses required by the state and local governing bodies such as the Department of Children and Families (DCF). Also, local zoning ordinances are necessary for the city’s approval. The cost of attorneys is required in every aspect of owning and operating a drug rehab.

Owning a Drug Rehab Requires Licensing and Accreditation

Many drug and alcohol addiction treatment centers are Joint Commission accredited, and this is a costly accreditation; however, it demonstrates that they adhere to the strictest standards. Therefore, many of the treatment centers get this certification. To receive this certification, many treatment centers hire outside consultants and spend large sums of money. Proper documentation and having a “policies and procedure manual” detailing all internal processes at a drug rehab facility is a requirement. These are typically lengthy manuals that require an educated and experienced individual to construct.

In addition, there is a business plan that business owners must put together which outlines all the requirements for a business to stay operational. In combination with this, individuals will need a Pro Forma which outlines all the costs associated with operating the business. On a monthly or yearly basis, a projection of earnings of up to five years is required.

To compile a Pro Forma, you must know how much the insurance companies pay for each care level. This information is generally available from a medical billing company based on an accumulation of data from a specific geographical area. The medical billing company will have information on how much the insurance companies are paying for all the different types of payers.

Drug Rehab Marketing

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Even with the medical component in place and the location up and approved, there is still the most challenging obstacle owners face daily. They need clients to be able to pay their bills and keep the doors open. This is one of the most challenging aspects of owning and operating a drug and alcohol addiction treatment center.

The competition is highly competitive. A handful of big players spend in excess of $500,000 a month in marketing to generate clients. This makes it extremely difficult for small and medium size substance abuse rehabilitation providers to survive. What are their options to generate clients?

The are only a few different ways for drug rehabs to generate clients. A thriving addiction treatment center will use a combination of these to sustain itself.

  • Google Ad Words and PPC
  • Drug rehab SEO (ranking organically on page one of Google for keywords)
  • Google Maps 3 pack – Ranking in the top 3 Google Maps (This is one of the best ways for small centers to beat the big ones.
  • “Boots on the Ground” – Referrals from other centers, private clinicians, the courts, hospitals, and more.

As you can see above, generating leads and new clients is difficult. Each one of the above requires financial investment and time. Even with all this in place and working correctly, there are still a few areas of concern left: admissions process and medical billing. We will cover both of these critical areas.

Admissions: Where Countless Dollars Are Lost Every Year – Get It Back with instantvob™

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Admissions are one of the areas that drug rehab owners must pay careful attention to every day. Drug rehabs allocate a tremendous amount of time, money, and energy to generate leads. A lead usually costs about $4,000, so rehab owners must capitalize on every phone call generated.

People are not looking for help only during business hours. A call for help can come, and usually does, on nights and weekends. Many drug and alcohol addiction treatment centers could not verify health insurance benefits then. The only thing they know for sure is the potential patient’s insurance.

We recommend the instantvob™ health insurance verification app for all drug and alcohol addiction treatment centers. This app will help save lives and help drug rehabs generate more admissions. The key factors needed to make the best decision possible by the admission staff have been outlined below. Learn more about why centers need to verify health insurance benefits here.

  • Insurance type
  • What is the deductible amount?
  • How much of the deductible is met?
  • What is the maximum out-of-pocket expense?
  • Is there any co-insurance?
  • Are there any co-pay factors?

These answers eliminate the risk of the addiction treatment center admitting this patient and also allow the admissions professionals to keep the individual seeking help on the line while they check this critical information. The process only takes about 10 seconds to get up-to-date and correct answers. If they find out they cannot help the patient due to financial concerns, they can advise them on other ways to obtain help with their current insurance benefit coverage. They could even have a conference call with the best potential addiction treatment center that offers coverage based on the patient’s insurance policy. This enables those with limited insurance benefit coverage to obtain their needed help.

Medical Billing Concerns – Providers Are Leaving over 20% on the Table!

Medical billing procedure improvements are one of the least scrutinized areas of operating a drug and alcohol addiction treatment center. Specifically smaller centers and some medium-sized facilities think they’re saving by doing their medical billing in-house, however, these facilities are losing and writing off more than 20% of their annual billing.

Hiring a well-staffed, experienced medical billing company in the substance abuse industry is a wise choice. They have the experience and human resources to negotiate with insurance companies. The insurance companies often stall and audit to delay payment long enough for the addiction treatment centers to write it off. Additionally, experienced medical billing company will also know the best ways to process claims and services, which is why we always recommend addiction treatment centers have a medical billing company audit their receivables every year. This evaluation could recoup countless dollars left on the table.

We Help Drug Rehab Owners Everyday

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If you are in the business of owning a drug rehab facility, we can help you in two key areas;  generate more admissions with our instantvob™ software and get advice on your revenue cycle management processes. On average, our clients get over 20% more reimbursements from overdue receivables and claims that untrained medical billers may have submitted incorrectly.

We appreciate drug and alcohol addiction treatment centers for what they do every day. They are saving lives and making a difference at this difficult time. The next time you think the owners of addiction treatment centers have an easy job, think about some of the things we covered in the article. There are many more reasons to admire substance use disorder treatment facility owners. We can only cover a little in a blog article.

We know running a drug and alcohol addiction treatment center is difficult. There are many different things owners must take care of every day. Call us at 561-530-5755, and let us help you save and generate more revenue.

 

 

 

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Instant Insurance Verification of Benefits – What You Don’t Know

Instant insurance verification of benefits is not a guarantee of payment. This phrase raises questions such as, “Why do insurance companies not pay a claim?” Why would the insurance company be so focused on this statement even after you verify the benefits of a particular policy that they would still include this disclaimer? It feels like they are already looking for a reason to avoid paying a claim, and you haven’t even admitted the patient. Isn’t the purpose of calling to verify the benefits to determine if the patient’s policy covers a particular level of care or ancillary service?

Instant Insurance Verification of Benefits Getting Lost in the Portal

Instant verification of Benefits with the specifics of each insurance company can be challenging. There are many different insurance companies. They all have self-service portals like Availity. Here are some others.

They all have their portals to provide self-service options. Doesn’t the word “verify” imply that the benefits are available to that patient? Well, it’s not that simple, and a plethora of information goes into the instant verification of benefits, billing, and collections.

It’s too familiar to revenue cycle managers when they see this complicated process. How can they differentiate what the patient’s benefits are? Do they also need to know how to bill the claim for the correct bill code? Many factors go into substance abuse building for a medical healthcare claim, from doctor’s notes to billing codes to even special regulations for specific insurance policies. When evaluating a medical claim based on the quoted insurance benefits, these all come into consideration.

The keyword is “guaranteed.” Even though you verify benefits, you could still make a mistake in any of these ways and more and not receive reimbursement. Instant verification of benefits is only the beginning step in submitting a claim to your insurance provider.

Why is Instant Verification of Benefits Complicated?

There is a lot that goes into the instant verification of benefits process. It is a complicated procedure. Here are some of the factors to be considered.

  • What is the deductible amount?
  • Are there out-of-pocket costs or co-pays?
  • What telephone number do I call if you need the information on nights and weekends?
  • Where do I go to find the self-service portal details online?
  • What if it’s after hours?

I have been on the phone with an insurance company, and the phone automatically disconnects right at closing time, despite waiting on hold for over two hours. I had never heard that wonderful phrase, “Verification of Benefits is not a guarantee of payment.”

What about finding that information accurately on nights and weekends in just one simple online portal; is that even available? What if a patient wanted to admit to your healthcare facility that was open on Saturdays? They show up with their particular insurance policy, and you have no way of verifying that policy over the phone. That’s where an online portal would be the next choice to see and verify that particular insurance benefit. As I have said, each insurance provider, such as Blue Cross Blue Shield, Aetna, and United Healthcare has different self-service portals for Benefits Verification. You have to log in to verify those benefits. And there is no guarantee that those portals will even be up and running.

instantvob™ Beats the Rest

Our instant insurance verification of benefits software does much more than the competition. instantvob™ demonstrates its efficacy with all insurance policies in one location. No more having to log in to multiple provider self-service portals on nights and weekends to verify insurance policy benefits. No more verification of benefits paper forms or letters. instantvob also gives you a “My VOBs” section to look at previous patients’ verifications, which can be convenient if a patient calls you on the phone and wants to set up a future appointment or for your substance abuse billing department to go back and look at the verification.

Why Drug Rehabs Need instantVOB™ 

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Built mobile-first, instant insurance verification of benefits has never been easier with instantvob. This tool can instantly verify hundreds of insurance policies in the palm of your hand. The verification of benefits form shows you everything from deductibles and out-of-pocket costs, even individual and family coverage levels. It also provides support for many different healthcare specialties. This tool has revolutionized how healthcare centers have verified benefits and increased revenue across the board to their customers. Most centers see a dramatic influx of patients due to the availability of providing accurate information to their patients promptly utilizing instantvob™. Avoid the need to tell patients, “I’ll call you back in an hour or two.” If you’ve ever worked as a front office manager of any healthcare facility, you know how much this frustrates the patient. Knowing that an estimated 90% of Americans are insurance dependent, whether private insurance, Medicare, or Medicaid, this information is paramount when verifying benefits.

Instant Insurance Verification of Benefits is Admissions Simplified

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Our instant insurance verification of benefits supports many healthcare specialties, including substance use disorder treatment. We are helping drug rehab CEOs get more admissions with our program. The team at instantvob™ has worked tirelessly to create the most intuitive and consistent platform for delivering insurance benefit verification data. instantvob™’s goal is for drug rehabs to access the most accurate data with the least friction possible. However, this doesn’t mean it is limited to the substance abuse and mental health market. Anyone from any healthcare specialties, medical billing, and pharmacy owners can utilize this information to make informed decisions for the patient’s care and, even more importantly, avoid surprises for the patient.

Insurance verifications are not a guarantee of payment. However, when you have the information in your hand of over 300 million other reimbursements, you can use the past to predict the future. You are still taking all the different steps to ensure your patient gets the clinical care needed and bills correctly for the financial care they deserve. Call us at 561-530-5755; we will help you get more admissions.