New Information Released Highlights Difference Between In-Network and Out-Of-Network Treat

(Newswire.net — June 8, 2017) West Los Angeles, CA — Many people who require substance use disorder treatment prefer to go to a geographical area sufficiently far from their personal community. However, new research indicates that lack of understanding of in-network and out-of-network PPO insurance has led to many of them not being able to access the treatment that they need.

Since the Affordable Care Act was instated, people have been delighted that far more health services have become available to them. While the administration of President Donald Trump aims to make significant changes to this particular act, it has been promised that this will not lead to less availability of treatment. This is of particular importance to those who have a substance use disorder (SUD), as it has made treatment a lot more available. However, it now appears that there is a significant lack of understanding of in-network and out-of-network PPO insurance, which is causing a great deal of confusion that has resulted in preventing some people from receiving the treatment that they need.

A representative from the Los Angeles Clinic, an SUD treatment facility in Los Angeles, CA, that focuses particularly on helping people who have been rejected by other treatment facilities, says: “I recently dealt with a case in which rehab was listed as ‘taking insurance’. A patient flew there from another state, only to find that the clinic actually only accepts PPO insurance. The result of this was that the patient was stuck in another state, struggling to stay sober. We worked very hard to find him an in-network provider, so that the momentum wasn’t lost.”

“It is vital that people understand the difference between ‘in-network’ and ‘out-of-network’ PPO insurance,” adds the representative. “They must have a full grasp of this before they commit to treatment. From a psychological perspective, if certain patients commit and then are unable to complete their treatment plans, it is unlikely that they will even make another attempt immediately, and this could have disastrous consequences.”

An in-network provider is one that has come to certain agreements with an insurance company in terms of discounted and negotiated rates. Typically, therefore, policy holders will pay less if they attend an in-network provider. These discounted rates have not been agreed upon with out-of-network providers, meaning that the policy holder will have to pay far more. It is quite common for insurance companies to complete to pay for out-of-network providers altogether.

The Los Angeles Clinic representative adds: “There are a few very important things to remember. First of all, the policy holder is responsible for finding out whether or not a provider is in or out of network. Secondly, just because a clinic says that they accept a certain type of insurance, does not necessarily mean that they are an in-network provider. It is vital that some research is done before enrolling, in other words.”

The Los Angeles Clinic encourages anybody looking for treatment to contact them to discuss their insurance policies, so that the best possible option can be identified for them.