“Our facility was continually being denied on insurance claims and reimbursements. Our documentation was not demonstrating sufficient terminology to demonstrate medical necessity of the services we were providing. The numerous instances of denials affected our bottom line,” said Brandon Corcoran, Operations Facility Director of Palms Detox.
Each position within a SUD facility requires different levels of training, and each person is speaking a different professional language.
Unfortunately, insurance providers only speak one language - Medically Necessary Criteria as determined by The American Society of Addiction Medicine. Without a commanding knowledge of ASAM Criteria, SUD facilities are unable to obtain reimbursement for their services.