Using UMR Third-Party Administrator (TPA) to pay for Rehab
Whether you suffer from a substance use disorder, a mental health condition, or co-occurring mental health issues (dual diagnoses), UMR health insurance plans can help you recover. UMR provides behavioral healthcare coverage to those seeking solace and recovery from substance addiction and other mental health disorders. If you have UMR health insurance, you may qualify for full or partial coverage of your inpatient and outpatient treatment needs.
Hotel California by the Sea’s addiction treatment programs in California, Washington, and Ohio typically accept those with UMR health insurance. With Hotel California by the Sea, you don’t need to worry about working out the nitty-gritty details of your health insurance coverage and specific health care benefits. We can verify your insurance benefits, making the process for you as easy as possible. Our highly experienced team understands how to get our UMR covered clients the best treatment possible for the lowest cost.
Does UMR cover Substance Abuse treatment?
Because UMR is a third-party administrator (TPA), it does not cover rehab directly. UMR works with providers and members to help you pay for your healthcare services and has a broad third-party network incorporating over two thousand providers nationwide. It is unique from traditional insurance models as UMR representatives work with the provider to ensure the highest standard of healthcare, including behavioral health services.
UMR supports rehabilitation as a necessary component of behavioral health services and takes a holistic approach to determine a client’s coverage. Instead of setting standard lengths of treatment, they will work with insurance companies and doctors to evaluate each client’s specific needs and determine the appropriate length of coverage.
Hotel California by the Sea along with UMR work to bring coverage to you for the following services:
- Inpatient detox.
- Residential inpatient treatment.
- Various outpatient programs (Partial hospitalization treatment, intensive outpatient treatment, and outpatient programming).
- Individual counseling and therapy sessions.
What is UMR?
UMR is a third-party administrator (TPA) entity under United Health Group. It defines itself by its flexible approach to healthcare and currently operates as the largest TPA in the nation. UMR incorporates over 4,000 customized plans designed within their policies to foster a more personalized experience with healthcare.
UMR fights for the fairest treatment prices for their members and acts as a middleman between insurance companies, providers, and members.
Understanding your UMR benefits
Simply reading online about substance addiction treatment coverage through UMR won’t work. Most UMR medical health plans and behavioral health benefits vary by the state one resides in. Other factors include copays, deductibles, and more. To learn more about how much of your inpatient rehab, outpatient programming and other substance abuse recovery services will be covered, you have many different options to utilize in finding the help you need.
If dealing with the details of your insurance coverage is too confusing, reach out directly to us. Hotel California by the Sea has a hotline fully staffed with various admissions experts. Our admissions experts can quickly run a verification of benefits for you. They can easily give you an estimate of the financial responsibilities you can expect from treatment services as well as what will be covered under your current plan.
At Hotel California by the Sea, you have the option to call our admissions specialists to verify your benefits, or you can fill out our 60-second verification of benefits form below.
INSURANCE VERIFICATION FORM
What is a Third-Party Administrator?
Insurance carriers are considered “risk-bearing entities”, meaning that these carriers assume the financial responsibility to pay for claims filed under their policies. Third-party administrators (TPA) handle administrative services on behalf of insurance companies and health plans through these insurance companies.
A Third-party administrator (TPA) is not a risk-bearing entity. UMR, a third-party administrator, will make decisions on claims and handles other tedious processes according to insurance policy. They are not ultimately the risk-bearing party. The responsibility is often on the employer that has utilized a TPA.
Advantages of UMR
We know that TPAs might sound a little bit confusing, but they make a positive influence on insurance carriers, their members, and treatment centers. For out-of-network treatment centers, UMR can help negotiate prices between members and their provider. For treatment centers who are in-network with UMR/United Healthcare, you can seamlessly plan your treatment journey with the assurance. There may be less work involved to get your insurance to pay for the majority of drug or alcohol addiction treatment.
In negotiating prices, UMR collaterally fights for the highest standards in behavioral health care. UMR, along with other TPAs, can prove beneficial for every party involved in the process of paying for rehab with health insurance.
Treatment for addiction at Hotel California by the Sea
Rehab for addiction and co-occurring disorders at Hotel California by the Sea has been a life-changing experience for the thousands of clients we’ve treated in our decade-long life as a company.
If you or a loved one is suffering from substance abuse issues, contact our admissions team at Hotel California by the Sea. We can help you understand what your financial responsibility will be before going to rehab so you know precisely what to expect. We will help you quickly understand what your insurance benefits are, how much of your treatment may be covered at our rehab, and plan the beginning of your treatment journey to recovery.
Request a Call
The road to recovery is full of uncertainty, leave your worries behind…
Our compassionate staff will answer all of your questions without any pressure. Learn about our evidence-based drug addiction treatment and rehab, the ease of entering our program, and the benefits of getting help from a reputable addiction treatment facility like Hotel California by the Sea.
Every member of our admissions team has been where you are today – be sure to ask them about their journey!