Drug Rehab -Insurance Billing
Many loved ones of patients who must go into a
drug or alcohol rehab facility have difficulty getting the insurance to
pay for the services rendered at the rehabilitation center. If the
rehab facility does not participate with the insurance plan of
the patient, it is the responsibility of the patient to get claim
filed. Unfortunately many times the claim must be filed on a UB04
claim form and no one knows how to complete these
claims. Often the facility doesn't accept insurance so
they do not file UB04 forms.
Insurance companies require
the claim be filed on a UB04 claim form to correctly identify
the procedures and diagnosis of the patient to initiate payment. The
patient or family member trying to get this claim paid gets caught in a
Catch 22. The insurance company is willing to pay, but they have no
way of submitting the claim in the correct format that will generate the
Even people who are familiar with medical
billing are not usually familiar with the UB04 claim form. Most
medical claims are filed on CMS 1500 forms and UB04s are entirely
different. They require different fields such as rev codes, value
codes and type of bill that are not required on a CMS
That's where we come in. We file UB04 claims for
drug and alcohol facilities and know how to get these claims paid.
We can file your claim for you correctly on a UB04 claim
how to get your insurance company to pay your claim when the rehab
facility is out of network or does not participate with your insurance
- Call your insurance company and ask for benefit
information. Explain to the customer service person that you are
calling on behalf of the patient who was admitted for drug and alcohol
rehab. Ask for out of network benefits for drug rehab. They
will explain to you if they cover this service when it is
performed by a facility that does not participate. In many cases out of
network benefits are available but may have a deductible involved.
- Ask how the claim must be filed - on what claim
- Find the
list of information
you will require to file the claim.
- Gather the required
information and start
the claim process. The cost of completing your
insurance claim is $250.
payment has been made you will be directed to an easy
wizard where you will enter the necessary information.
- We receive the information and complete the UB04
form in the correct format and submit it electronically when possible to
the insurance carrier.
- We will
notify you that the claim has been
submitted. Most insurance companies pay claims within 30
days. Some may take as long as three months. You may call
your insurance company and check on the claim status. We cannot
guanantee that the insurance company will pay. You need to do
your homework up front and check your benefits. We will file
the claim correctly. If a resubmission
is necessary we will file the necessary resubmission free of
Call us for more information at
home from Drug