Demystifying Insurance
Embark Behavioral Health strives to demystify the concept of insurance billing for our families.
We understand insurance billing is a difficult process, which is more complicated in the behavioral health industry.
We will walk you through the steps of verification of benefits, determining if you have the proper coverage to bill the insurance, what the authorization process entails, and submitting claims to the insurance for coverage.
Step 1:
Gathering Information
To get things started, we will begin to gather information regarding your insurance policy, which includes the client’s name, DOB, policy holder, policy holder DOB, address, and a picture of the front and back of the insurance card. We will also need to obtain clinical and treatment history. Once this information is collected, we can begin the work of obtaining a Verification of Benefits.
Step 2:
Verification of Benefits
During the Verification of Benefits, we will consult with your insurance company and will obtain authorization requirements for each level of care. This includes Residential Treatment (RTC), Partial Hospitalization Program (PHP), Intensive Outpatient Program (IOP), or Outpatient (OP). After this consultation occurs, we will partner with you to understand what to expect along the way.
Step 3:
Utilization Review
If a precertification is required, our Utilization Review team will review clinical documentation collected prior to enrollment and the assessment completed by our clinician. The clinical document prior to enrollment is comprised of testing, letters, and assessments. The Utilization Review team will compile the case and begin communicating with the insurance provider.
The No Surprises Act protects people from receiving surprise medical bills for most emergency services and non-emergency services from certain providers. Learn more about the No Surprises Act. If you are an existing patient and have questions about your billing, call (661) 622-4132. If you are a new patient and have questions, call Admissions at 866-479-3050.
We work with most insurance companies. Contact us and we will walk you through a free insurance verification.
All Savers
Allegiance Benefit Plan Management Inc
Allied Benefit Systems
Anthem
GEHA
Anthem CA
BC of PA - Capital
BC of PA - Independence
Anthem GA
Carefirst
BCBS MT
BCBS of PA - Highmark
BCBS TN
Regence BCBS UT
Group and Pension Administrators
Anthem VA
Beacon
BS CA
CIGNA
BCBS W NY
ComPsych
EMI Health
First Health
Harvard Pilgrim Health Care
Health Plan of Nevada
Humana
Johns Hopkins Healthcare
Kaiser
Kaiser - Mid-Atlantic
Kaiser of WA
Lifewise of Washington
Magellan
Meritain Health
MHN-Managed Health Network
Nippon
PacificSource
Prairie States
Quest
SelectHealth
Tufts Health Plan