Navigating Insurance: Working with an Insurance Advocate

Balancing your addiction treatment needs with your financial resources can be a difficult process; you may desire the high quality of care a private pay facility can provide, but you are concerned about carrying the full cost of treatment. What you may not realize is that many insurance plans will cover part of the cost of treatment, even if you choose an out-of-network treatment program. However, navigating out-of-network insurance claims can be an overwhelming prospect and add more stress to an already stressful situation. By working with an insurance advocate, you can let an experienced professional handle your claims and ensure that you receive maximum reimbursement from your insurance company to minimize your out-of-pocket expenses, giving you the financial breathing room to afford the care you need.

If you would like a referral to a trusted insurance advocate or have questions about addiction treatment, we encourage you to contact us.

What Is an Insurance Advocate?

A professional insurance advocate is a third-party vendor who bills your insurance company on your behalf and advocates for you to get the most out of your benefits. Because they are independent vendors who are hired by you rather than the treatment facility or your insurance company, their interest is solely in helping you maximize your reimbursement.

How Does It Work?

Your insurance advocate will gather all necessary paperwork from you and your treatment provider and submit insurance claims directly to your insurer along with any supporting documentation. At a time when you and your family are focused on the recovery process, handing the responsibilities of insurance claims to a knowledgeable professional can be a relief in and of itself; rather than worrying that you are missing an important document or billing code, you can concentrate on your healing. But insurance advocates do more than just submit paperwork—they also use their in-depth knowledge of both the insurance and healthcare industries to:

  • Navigate insurance requirements.
  • Identify discrepancies between your explanation of benefits and the coverage you receive.
  • Identify billing errors.
  • Dispute and appeal denied claims.
  • Answer any questions and concerns you may have about your insurance claims.

As such, these skilled professionals can be an invaluable part of your care team and help ensure that you are able to afford the treatment you need to heal from the pain of addiction.

How Much Does It Cost?

Insurance advocates typically charge you a percentage of your reimbursement. This means that it is in their best interest to get you the best reimbursement rate possible.

How Do I Find an Insurance Advocate?

At Alta Mira, we can refer you to a trusted network of professional insurance advocates with years of experience helping their clients get the most out of their benefits. All the insurance advocates we recommend are independent vendors who are hired directly by you (generally working for a percentage of the insurance monies reimbursed) and do not receive compensation from the treatment program you select, ensuring that they work only for you, not your care provider. If you would like to connect with an insurance advocate or would like more information about any aspect of addiction treatment, we invite you to contact our admissions counselors at any time.