Financial Office and Utilization Review
Avalon Hills Financial Office and Utilization Review Department are committed to partnering with families to promote treatment and recovery. We demonstrate this by teaming together the experience of Avalon Hills and dedication of families to expand the financial resources available for treatment.
Even when an insurance benefit is in place, policy holders must justify using it. Our finance manager and utilization review nurse spend hours every day on the phone with insurance companies explaining how our program works and why allowing and continuing treatment is necessary to improve and save lives. On a continuing basis we collaborate with the members of the multi-disciplinary treatment team to understand each individual case, so that we may speak on behalf of the client. When necessary, the utilization review nurse coordinates phone calls between treatment team members and the insurer’s medical director or psychiatrist.
If a family pursues appeals, Avalon Hills provides the combined support of utilization review and our financial office. We offer advice based on our experience, make phone calls with insurer and/or send medical records to the insurance company. We inform families of the power they have and the type of work they can do to give an appeal the best chance of success. This is a process that we continue to assist in well after a client discharges.
We understand that even with all of our efforts there are times that claims will be denied or benefits will run out. Our financial office is proactive about educating families on alternative sources of funding and providing scholarship and/or financial assistance applications in hopes of continuing treatment.
