{"id":8761,"date":"2019-12-20T20:25:50","date_gmt":"2019-12-20T20:25:50","guid":{"rendered":"http:\/\/hnetalk.com\/member\/?p=8761"},"modified":"2019-12-20T20:29:04","modified_gmt":"2019-12-20T20:29:04","slug":"clinical-stabilization-services-coverage-for-substance-use-disorders","status":"publish","type":"post","link":"https:\/\/hnetalk.com\/member\/clinical-stabilization-services-coverage-for-substance-use-disorders\/","title":{"rendered":"Clinical Stabilization Services Coverage for Substance Use Disorders"},"content":{"rendered":"<p>As a Health New England member, you have Behavioral Health coverage, which includes mental health\u00a0and substance use disorder services.<\/p>\n<p>With a recent rise in the use of detoxification and short-term residential rehabilitation services, also\u00a0known as clinical stabilization services (CSS), some questions have come up about what is covered for\u00a0residential care and if payment is required up front.<\/p>\n<p>Below are details to help clarify what Health New England covers for CSS and payment details for\u00a0members:<\/p>\n<ul>\n<li>Health New England covers detoxification and\/or short-term residential rehabilitation, also<br \/>\nknown as CSS, at facilities licensed by the Massachusetts Department of Public Health (DPH)<br \/>\nBureau of Substance Abuse Services for a minimum of fourteen (14) days combined. After the<br \/>\n14 days, requests for additional coverage are reviewed for medical necessity.<\/li>\n<li>CSS facilities should not request payment in advance (except for applicable member cost share<br \/>\nfor CSS); nor should they claim that expenses for services provided after 14 days will be<br \/>\nautomatically covered. Services after 14 days require Health New England review\/approval<\/li>\n<li>If a facility requires payment in advance in order to treat the member or makes claims about<br \/>\nwhat Health New England will cover, please consider this a red flag. Please contact Health New<br \/>\nEngland Member Services if this does occur.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>We have also observed an increase in members receiving CSS at out-of-network facilities. Please note,\u00a0Health New England has a broad network of facilities that offer CSS in both our HMO and PPO networks.<\/p>\n<p>For questions and more information about covered services and member responsibility, or help finding\u00a0an in-network CSS provider, please call Health New England Member Services at (413) 787-4004 or toll-free at (800) 310-2835.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>As a Health New England member, you have Behavioral Health coverage, which includes mental health\u00a0and substance use disorder services. With a recent rise in the use of detoxification and short-term residential rehabilitation services, also\u00a0known as clinical stabilization services (CSS), some questions have come up about what is covered for\u00a0residential care and if payment is required [&hellip;]<\/p>\n","protected":false},"author":11,"featured_media":8762,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[19],"tags":[],"class_list":["post-8761","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-newsletter"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/hnetalk.com\/member\/wp-content\/uploads\/2019\/12\/GettyImages-1126063609.jpg?fit=2121%2C1414&ssl=1","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZGa-2hj","_links":{"self":[{"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/posts\/8761","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/comments?post=8761"}],"version-history":[{"count":1,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/posts\/8761\/revisions"}],"predecessor-version":[{"id":8763,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/posts\/8761\/revisions\/8763"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/media\/8762"}],"wp:attachment":[{"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/media?parent=8761"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/categories?post=8761"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/tags?post=8761"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}