Insurance & Payment Information

Currently, Timberline Knolls has agreements with insurance companies like Aetna, BlueCross BlueShield (BCBS), Beech Street,CIGNA, ComPsych, Humana/Corp Health, Integrated Behavioral Health (IBH), Magellan Health, MultiPlan, Three Rivers, ValueOptions as well as Tricare (Tricare dependents (ages 12 to 20) of any active duty servicemen or servicewomen) to manage the costs of treatment.

The daily rate for residential treatment at Timberline Knolls includes all clinical, educational, psychiatric, behavioral/milieu, nursing, and expressive therapeutic services on a 24-hour, 7-days-a-week basis. Individual, family, and group therapies are included. The daily rate also includes all meals and lodging. It is based on a tuition model of monthly billing. Services that are not included are non-psychiatric medical services, such as pediatrics, gynecology, dentistry, dermatology, hospitalization, urgent care, emergency care, urine/blood/lab work, medications, etc.

To help you understand the financial review process at Timberline Knolls (TK), we have listed out the typical steps that begin with your first call to TK.

• Insurance Benefits Verification
  • You contact your company’s Human Resource Department Benefits Administrator and your Insurance Provider to see if you have an RTC (Residential Treatment Center) benefit.
  • Timberline Knolls will also contact your insurance company and request information about your Mental Health benefits, specifically the benefit for RTC, the primary level of care offered at TK. This quote of benefits is NOT a guarantee of coverage.
  • Note that treatment history is an essential component for most Insurance Providers to consider funding RTC level of care. Many companies require that a patient has tried other levels of care, such as inpatient, PHP (Partial Hospitalization Program) or IOP (Intensive Outpatient Program) prior to being eligible for RTC admission and treatment.
• Financial Options Review
  • An Admissions Coordinator will review your insurance policy benefits and your clinical history to provide an opinion on likelihood of insurance authorizing coverage for residential care at this time.  This is never a guarantee.
  • You then take that information and determine for yourself how to come up with any funds not covered by insurance during your stay.
• Insurance Authorization Process
  • Your first 5-7 day’s insurance authorization is based upon a clinical evaluation within 72 hours of your arrival at Timberline Knolls. In rare cases the Insurance Provider could decide that RTC treatment is not medically necessary and will not authorize payment for your stay.
  • Insurance Providers will typically authorize payments in 5-7 day increments, starting with your first day on campus.
  • An Insurance Provider may decide to discontinue paying for RTC treatment after each of these intervals, based on their specific Medical Necessity Guidelines and screening criteria.

The length of time that insurance authorizes for coverage is not determined by Timberline Knolls and may not always coincide with your treatment team’s recommendation for length of stay. If this happens, you may need to consider an alternate funding source to complete the length of treatment recommended by TK. We typically recommend a minimum of 30 days.

• You Decide to Come to TK
  • If you are comfortable with the financial risks and obligations of RTC treatment, we will confirm and schedule your admission.

• Each individual insurance benefit plan is different. Some of the variations may be subtle and limitations of the plan can be easily over-looked. Be sure to verify your benefits with your company’s Human Resource Department Benefits Administrator and your Insurance Provider.
• In the case of a difference in opinion between TK and your insurance company about medical necessity of residential care, you may receive a denial of coverage for ongoing care at the residential level. Typically when residential care is denied, your insurance company will provide a recommended level of care (PHP, IOP or outpatient).
• Upon denial of coverage, TK will notify the patient/guarantor in a timely manner when the Insurance Provider provides us with a notification of denial and we will inform you of your options, which can include appealing the decision or helping you find the appropriate treatment program for the level of care your Insurance Provider recommends.
• The outcome of any appeal discussion between TK and your insurance company may take one to three business days.

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If you have additional questions or need more information, please contact our Admissions Department.