Wellness Resource Center is excited to announce that we have officially become an in-network provider for Beacon Health Options! Beacon (originally Beacon Health Strategies and Value Options before their merger in 2014) provides behavioral health solutions for specialty health plans, such as labor organizations, federal, state and local governments, and Fortune 500 companies. Beacon Health Options serves over 50 million members across the United States. Beacon states that its “care is focused on the individual, providing tailor-made solutions at the local level and a true understanding of the populations [Beacon] serves.” As an insurer specializing in behavioral healthcare, Beacon emphasizes treatment solutions for mental illness and addiction. Wellness Resource Center has partnered with Beacon because we share that same dedication to providing a complete continuum of treatment to our dual diagnosis clients.
Why Beacon Health Options?
Prior to this year, Wellness Resource Center already accepted Beacon Health Options on an out-of-network basis, as we do for most major insurance companies. By becoming an in-network provider with Beacon, Wellness Resource Center is now able to offer our dual diagnosis partial hospitalization and intensive outpatient levels of care to more Beacon Health members who do not have out-of-network benefits. Because Beacon Health Options manages the behavioral health (e.g., substance abuse and mental health) portion of many different insurance policies, Wellness Resource Center can now provide addiction and co-occurring mental health rehabilitation to individuals who would not otherwise qualify for our specific treatment services. This includes roughly 5.4 million military personnel and their family members who are covered under Beacon Health Options policies. Our experienced staff is honored for the opportunity to treat our US military and veterans suffering from chemical dependency and trauma/PTSD, as well as federal and other government employees covered under Beacon Health Options.
What Does Being In-Network Mean?
Being an in-network provider with your insurance company means that Wellness Resource Center is contracted to provide dual diagnosis treatment at the levels of care offered through our program to all members covered by that insurance company. As an in-network provider, we have already negotiated set, discounted rates with your insurance company, meaning less cost for you as a patient. Many insurance policies include a deductible (the dollar amount that must be met before your insurance company begins covering services), a co-insurance or co-pay (a set percentile or dollar amount that the member is responsible for per day or visit) and an out-of-pocket maximum (the maximum amount a member will spend before they are completely covered by insurance). For most insurance policies, the deductible, co-insurance, and out-of-pocket maximum are higher for out-of-network providers than they are for in-network providers, meaning the member will likely pay more for the same services from an out-of-network provider than they would with an in-network provider.
Here is an example of the difference between in-network and out-of-network benefits, given by another insurance company that is in-network with Wellness Resource Center, Blue Cross Blue Shield of Michigan:
When a provider joins our network, they agree to accept our approved amount for their services. For example, a doctor may charge $150 for a service. Our approved amount is $90. So as a Blue Cross member, you save $60.
On your claims and explanation of benefits statements, you’ll see these savings listed as a discount.
Doctors or hospitals who aren’t in our network don’t accept our approved amount. You’ll be responsible for paying the difference between the provider’s full charge and your plan’s approved amount. That’s called balance billing.1
In addition, certain types of insurance plans like health maintenance organizations (HMOs) do not have out-of-network benefits, limiting the number of treatment options for those covered under HMOs and similar plans.
As one of the original Florida Model treatment centers in South Florida, and as a nationwide destination for true dual diagnosis treatment, we at Wellness Resource Center look forward to offering our unique services to the entire Beacon Health family. Our focus at Wellness Resource Center is to provide comprehensive care to complex clients struggling with substance use disorders and co-occurring mental health problems. Our program, with its extended care options, personalized treatment approaches, individualized lengths of stay, and step down continuum is in perfect alignment with Beacon’s dedication to full-spectrum, high-quality behavioral healthcare.
Wellness Resource Center is also an in-network provider with Aetna, Cigna, United Healthcare, and Blue Cross / Blue Shield. WRC services not only the state of Florida but accepts insurance policies from across the country. To learn more about our dual diagnosis program, please give us a call today and one of our friendly and knowledgeable admissions coordinators will be happy to help you.
1 https://www.bcbsm.com/index/health-insurance-help/faqs/topics/how-health-insurance-works/difference-between-in-network-out-of-network-benefits.html
