Health insurance denials are irritating the best of circumstances. When it comes to addiction treatment center insurance denials, the consequences can be life and death. Understanding how to quickly appeal a bad decision made by some of the biggest insurance providers - like Centene Corporation - is a key component of acting as an essential lifeline and advocate for SUD patients.

First, What is Centene Corporation and What’s Their Place in the Addiction Treatment Insurance Universe? 

Centene Corporation began as a non-profit managed health care agency in the 1980’s but went public in the early 2000’s. It quickly moved into pharmacy benefits, correctional health care, federal healthcare plans for the Department of Defense, and state-run Medicaid programs. Centene acquired several healthcare entities over the years, with the highest-value acquisitions being Well Care in the United States and Circle Health in the UK. Centene dominates the Health Insurance Marketplace established by the Affordable Care Act and is the largest Medicaid managed care company in the United States. 

The Many Centene Corporation Health Insurance Plans You’ll See at Your Addiction Treatment Center: Medicare, Medicare Advantage, Medicaid, Ambetter, HealthNet, Fidelis Care, Ascension Complete, Centurion, etc 

Centene Corporation plans are known by many different brand names, which vary depending on the location and type of insurance offered. This can be confusing. 

Centene’s Health Insurance Marketplace plans are mostly branded under state-specific names or Ambetter, but they also operate as HealthNet on the west coast and Fidelis Care in New York. The majority of patients with these plans receive government subsidies to offset the cost of their premiums. 

Centene Health’s state specific brand names range from the Buckeye Health Plan in Ohio to Superior Healthplan in Texas. Some of these brand names cover a state’s Medicaid, Medicare and Health Insurance Marketplace plans, meaning you can’t always tell which type of insurance the patient has based on state-specific brand name alone. 

Centene Corporation also offers correctional behavioral health services under the brand name Centurion in most states. 

Expedited Appeal Vs. Regular Appeal: Why the Difference Matters in Addiction Treatment 

By law, standard insurance appeals at Centene Corporation may take up to 30 days. For those of us who work in behavioral health, it's obvious that waiting this long for an insurance appeal could be fatal to the patient. 

Enter the expedited appeal. In contrast to a standard appeal, an expedited appeal - also known as a fast appeal, a quick appeal, an expedited reconsideration or an emergency appeal - must receive a response within 24 to 72 hours. If a decision is rendered over the phone or “verbally” within that time frame, then Centene Corporation must also follow that up with a written response within 72 hours. 

How to Request an Expedited Appeal for Addiction Treatment from Centene Corporation Using the Expedited Appeal Line 

Unfortunately, there is no single line to call to request an expedited appeal from one of Centene Corporation's managed healthcare brands. Every plan will have a different point of contact and a slightly different process for handling appeals, including requests for expedited appeals. 

You’ll need to search for the exact brand name’s plan and go from there. A good search term might look like, “(brand name) appeal process” or “(brand name) expedited appeal.” 

For example, if you’re in California and you’re dealing with a HealthNet appeal, you can visit that brand’s specific appeals and grievances page. There, you’ll find a member appeal form as well as a fax number for directing completed forms: 1-844-273-2671. You may also want to contact member services to see if you can begin the process verbally.   

Tired of Searching for Yet Another Expedited Appeal Line for Centene Corporation? We Can Help.

You’re not the first addiction treatment professional to get fed up with behavioral health billing. The process changes constantly, is incredibly tedious and requires an extraordinary attention to detail. 

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 - (including expedited appeals!) 

Get your free trial started today and see why more addiction treatment centers prefer Behave Health.