Medical Billing Forum

Billing => Facility Billing => : HavenBilling March 03, 2018, 10:42:38 AM

: Need help with Detox Rates!
: HavenBilling March 03, 2018, 10:42:38 AM
California Biller here, Chem Dep Sub Abuse Detox, RTC, PHP and IOP. We are contracted with some carriers and I pretty much know the rates around here. CEO is looking to expand to East Coast and asked I spear head the beginning phases of planning. I’ve tried to explain that fee schedules are impossible to know before you’re in network. His whole thing is that he doesn’t even want to try and open the facility if the rates will be too low to keep the doors open. He and I have both heard $300-$400 per died for detox over in New York. Which is really shocking to us because we aren’t close to that here in California and sometimes it still seems hard to stay a float! I don’t know how you could provide such an intense level of care for that cost? Anyways, if someone can provide insight. For commercial insurances, are the detox and/or RTC rates closer to $300 or closer to $1000?
: Re: Need help with Detox Rates!
: PMRNC March 03, 2018, 11:52:42 AM
Where in NY? I'm in the Adirondack region upstate and I believe Alice and Michele (owners of this forum) are in Rochester area?

: Re: Need help with Detox Rates!
: HavenBilling March 03, 2018, 01:56:28 PM
Hi, thanks for your response! I did speak with Michelle, who was helpful! There isn’t a lot of information for New York in general. I believe he’s looking near Long Island and near Brooklyn. Everything I’m hearing thus far indicates painfully low rates from commercial carriers. The numbers of like $300-$400 are unheard of here in CA!
: Re: Need help with Detox Rates!
: Nick D September 13, 2019, 02:50:43 PM
OON: detox I bill around 3.5k and rtc around 3.2k and haven't received any push back. I choose to negotiate with the 3rd party vendors and receive a comfortable percentage of billed charges.