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How to Handle Utilization Reviews with Blue Shield of California for Addiction Treatment

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While they’ve done things like make nominal financial contributions to the cause of diversifying the mental healthcare profession, Blue Shield of California is part of a general trend in managed care to minimize costs for insurers by limiting the scope of “medical necessity,” especially when it comes to addiction treatment.

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Prior Authorization with Molina: Addiction Treatment Guide

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Prior authorization or precertification is required by most health insurance companies for many behavioral healthcare and addiction treatment services, and Molina Healthcare is no exception.

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4 Quick Tips for Managing Addiction Treatment Discharges with Independence Blue Cross

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Here’s 4 quick tips for understanding addiction treatment discharges with Independence Blue Cross.

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Finding Addiction Treatment Billing Contact Information for Blue Cross Blue Shield Association Corporation

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Every state has a different BCBSA company with different addiction treatment billing contact information. To make matters even more confusing, some states have more than one BCBSA company operating within their borders!

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What Addiction Treatment Diagnosis Codes Should I Use for URs With Health Care Service Corporation?

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HCSC has a history of denying addiction treatment claims by using overly restrictive guidelines that contradict the APA’s clinical opinion. It’s critical that you use the correct diagnosis code for every HCSC UR.

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How to Use Humana's Clinical Guidelines for Behavioral Health in Your Addiction Treatment Center's Billing Department

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Learn what you can do at your addiction treatment center’s billing department to leverage Humana’s behavioral health clinical guidelines to maximize reimbursements.

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Guide: Cigna Billing Claims Address for Addiction Treatment

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If you’re a behavioral health provider, you probably don’t actually want a billing claims address for Cigna at all.


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What's the Average Length of Stay Per Level of Care for Addiction Treatment Patients with Kaiser Foundation Health Plans?

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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.

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Everything You Ever Wanted to Know About Aetna Precertification for Addiction Treatment Billing

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When it comes to addiction treatment, Aetna uses the terms precertification and preauthorization interchangeably. Aetna may also refer to this concept as Authorization, Certification, Prior authorization, or Pre-service utilization review .

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What Anthem Inc's Level of Care Denial Rates Mean for Your Addiction Treatment Center's Billing Department

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Who is Anthem, Inc? What are their average denial rates and how do they compare to the industry average? What levels of care are most likely to be denied by Anthem, Inc? What can your addiction treatment center do to fight back against behavioral health care denials from Anthem, Inc?

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How to Quickly Appeal a Centene Corporation Health Addiction Treatment Claim Denial Using the Expedited Appeal Line

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Understanding how to request an expedited appeal from big addiction treatment insurance providers - like Centene Corporation - is a key component to advocating for SUD patients.


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How to Determine the Medical Necessity of Addiction Treatment Services for UnitedHealth Group, Inc

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Got questions about working with addiction treatment and UnitedHealth Group Inc when determining the medical necessity (or if treatment is medically necessary)? Here’s how it works.

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Mastering ASAM Criteria for Addiction Treatment | Behave

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Whether you refer to it as the “Six Dimensions,” The ASAM Criteria or simply a “biopsychosocial,” the ASAM Criteria has come to dominate the landscape of multidimensional assessment in the addiction treatment community.

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FAQ: Opening and Licensing an Addiction Treatment Center in Nebraska 

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Despite the challenges, Nebraska represents a strong opportunity for those looking to open an addiction treatment center. Here’s how certification, licensing, bed fees and state inspections work in Nebraska.

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Opening an Addiction Treatment Center in New Mexico? Here’s What You Need to Know.  

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Like most states in the US, New Mexico requires all “alcohol and drug abuse hospitals” to maintain a current license on file with the state.

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Opening an Addiction Treatment Center in Kansas: Low Fees and a Relatively Easy Process 

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In terms of “market demand,” there’s no question that Kansas needs new addiction treatment centers. Here’s how to open a rehab and get licensed in the state.


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Pros and Cons of Opening an Addiction Treatment Center in Mississippi

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Anyone looking to open an addiction treatment center in Mississippi has a big job ahead of them.


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Opening an Addiction Treatment Center in Arkansas? Here’s How to Get Started and Get Licensed

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It’s not terribly difficult to open a treatment center in Arkansas. The state’s licensing process is straight-forward and the Arkansas Office of Alcohol and Drug Abuse Prevention (OADAP) makes it relatively easy to access information about how to get started.

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Opening an Addiction Treatment Center in Nevada Should be Easier. Here’s How to Complete the Process.

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Nevada is a state in desperate need of more licensed addiction treatment centers.

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Opening an Addiction Treatment Center in Iowa? The State’s Long-Standing SUD Problem Is Getting Worse, Not Better

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Addiction treatment centers looking to get licensed in Iowa face high rates of alcoholism, increasing overdose deaths, access problems in rural areas and underserved populations. Still, Iowa is a great place to open an addiction treatment center.