What are Kaiser Foundation Health Plans? When Might Addiction Treatment Providers See This Type of Insurance?
Kaiser is a slightly different insurance company than most.
Kaiser Permanente is the parent entity that manages the Kaiser non-profit insurance empire. It is an integrated managed care consortium based out of California. It is one of the largest non-profit healthcare plans in the US. Serves over 12 million members and nets 2.2 billion annually. Kaiser is available in California, Colorado, Georgia, Hawaii, Maryland, Virginia, Washington DC, Oregon, and Washington state.
Kaiser Permanente is made of three different entities: Kaiser Foundation Health Plan, Inc, Kaiser Foundation Hospitals and the Permanente Medical Groups.
To be specific, “Kaiser Foundation Health Plan” refers to the membership organization that the Permanente Medical Groups serve.
According to one report, most Kaiser patients are middle class professionals who prefer outpatient treatment when it comes to behavioral healthcare so as to minimize the number of days they need to take off work. It may be that you see fewer residential patients at your addiction treatment center with Kaiser Foundation Health Plans for this reason.
What’s Kaiser’s Track Record for Behavioral Health and Addiction Treatment Coverage Like?
In a word, not great.
The plan was recently fined $4 million dollars for failing to provide adequate mental health care in California.
Kaiser’s own clinicians have struck several times in protest of long patient wait times, scheduling difficulties and unethical denial practices. While the HMO cites counselor vacancies as the issue, claiming it cannot fill some 300 vacancies in the state of California alone, clinicians who work at the HMO say that the attrition rate and slow hiring pace has more to do with unethical practices and high caseloads than it does with a true shortage of clinicians.
What Does Kaiser Say About the Average Length of Stay Per Level of Care for Addiction Treatment?
According to Kaiser’s website, it depends.
Among other non-specifics, Kaiser offers these fuzzy details on what patients can expect in terms of length of stay for addiction treatment:
“How long you stay varies among programs.”
Inpatient care can last “anywhere from 1 to 6 weeks.”
Length of stay depends on “how your recovery is going.”
Residential treatment can last “for months,” in some cases.
What Does the Data Say About the Average Length of Stay Per Level of Care for Addiction Treatment with Kaiser Foundation Health Plans?
Although it is difficult to find information, especially current information, on the average length of stay Kaiser Foundation Health Plans will authorize for residential addiction treatment, there are some clues to be found in one 2018 report produced by the state of Oregon.
Here’s the most revealing information from this report for addiction treatment providers and addiction treatment billing departments:
The average addiction treatment detox stay for a Kaiser Foundation Health Plan member was 4 days.
The average residential treatment for SUD for a Kaiser Foundation Health Plan member is 13 days or just under 2 weeks.
Outpatient treatment duration was not given in the report, but it was noted that most outpatient treatment recipients were “still engaged after 90 days,” suggesting these programs are usually covered at least 3 months on average.
Want to Get a Longer Length of Stay Covered for Addiction Treatment Patients with Kaiser Foundation Health Plans? We Can Help.
You’re not the first addiction treatment professional to have this problem.
Getting Kaiser to cover an adequate length of stay for addiction treatment patients - particularly residential patients - can be frustrating.
BehaveHealth’s Revenue Cycle Management (RCM) service includes soup-to-nuts, hyper-detailed, hands-on attention to every single component of your addiction treatment billing needs. We have strong working relationships with every major insurance company in the United States.
Even better, we’re not health care generalists. We only work for behavioral health providers like you.
Let our team of specialists handle it all:
Verification of Benefits
Utilization Review
Billing and Collections
Patient Responsibility
Denials and Appeals
Get your free trial started today and see why more addiction treatment centers prefer Behave Health.