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April 14, 2024
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Networks by Design Addiction Treatment Coverage
Networks by Design is a California-based preferred provider organization, with a network of thousands of doctors, clinicians, clinics, and treatment centers across the state. The network is a relatively small one, which allows it to offer local contracts and contracted rates to the insurance providers it works with. However, Networks by Design does not offer insurance coverage directly. This means you cannot get direct treatment coverage from Networks by Design. However, your insurance provider may work with the provider network to ensure you get lower rates on your addiction treatment.
This means that if you want to know what addiction treatment coverage you can get through Networks by Design, you’ll have to check your actual provider. However, knowing that you work with Networks by Design means that you can get lower rates by choosing one of its in-network addiction treatment centers.
Does Networks by Design Offer Addiction Treatment Coverage?
Networks by Design offers a large network of providers including clinics, doctors, therapists, rehab clinics, outpatient addiction treatment centers, and more. This means that if your health plan provider has a contract with Networks by Design, you can use any provider on that network to get addiction treatment services offered.
In most cases this will include:
Inpatient Care
Most of Networks by Design’s rehab centers offer inpatient care, which means you can have it covered, with preferred provider discounts.
Outpatient Care
You’ll have a choice of several hundred outpatient recovery programs with Networks by Design.
Emergency Services
Networks by Design maintains a large network of emergency services, so you can have emergency care and treatment covered.
Detox
Networks by Design offers some detox clinics, meaning you can request those services via your doctor.
Therapy
You can opt into therapy including supplementary therapy and aftercare programs with providers in the Networks by Design network.
However, this is just what Networks by Design offers. If you want to see actual coverage, you’ll have to look at what your health plan offers. That can vary quite a bit depending on your employer, what your Medicaid program offers, etc.
What is a Provider Network?
A Provider Network is a group of healthcare professionals who have signed a contract to work for contracted rates. This typically means they receive approval and preference from an insurance program. In return, they offer discounted rates to persons holding that insurance. A network means that a single network can negotiate to work with multiple insurance providers, meaning that insurance provider can ensure the best possible in-network coverage to its users.
In the case of Networks by Design, that means a network of several thousand healthcare providers across the West Coast. This enables you better access to affordable healthcare, providing your actual policy also offers coverage.
Who Does Networks by Design Work With?
Networks by Design works with a large number of insurance providers including Medicaid, Medicare, private insurance policies, and primarily with employer-provided healthcare plans. This means that if you have a healthcare plan provided by your employer, there is a chance it works with the Networks by Design network. Here, the only thing you can do to check is to review your policy and/or call your insurance provider to ask for details on who it works with and what their preferred provider list is. However, not all insurance providers will disclose their networks and will instead give a list of providers or ask you to verify in-network status with your rehab center on an individual basis. In each case, verifying that your rehab center is in network will generally be up to you and your insurance provider may charge surprise bills if you go to an out of network treatment center.
Why Choose an In Network Rehab Center?
If you’re looking for addiction treatment, going for an in-network provider can save you a lot of money.
In fact, it offers numerous benefits including:
Reduces Costs
Networks by Design negotiates lower rates with its network so that you can reduce out of pocket charges as much as possible.
Faster Approval
Many in-network providers are essentially pre-approved. This means that you won’t have to wait for pre-authorization to get treatment. However, you will likely still need a digital filing and a doctor’s referral depending on your policy.
Convenience
If you’re using your network, you can simply search for providers in your network. That makes it easy to find reputable and vetted addiction treatment providers. If you search outside that network, you can still get treatment. However, you’ll have to do the vetting and wait for preauthorization yourself.
Essentially, it’s generally a good idea to work with your provider network if you’re using a PPO. However, even if you don’t have to, doing so can save you money and will reduce costs and hassle over going to an out of network treatment provider.
How to Get Started with Networks by Design?
If you’re looking for addiction treatment the process starts with your insurance policy. Here, you’ll want to check where it’s from, what it covers, and what your deductibles are. This typically means looking at your employer-provided health plan, as that’s mostly what Networks by Design works with. From there, you can review your deductibles, what’s covered, and when. That should include things like your deductible, your coinsurance or copay, your maximum out of pocket expenses, etc. You’ll also want to check if you pay more for going to inpatient instead of outpatient treatment.
From there, you can either look for a rehab center and verify that it works with your insurance policy. Or, you can use Networks By Design’s website to look for a rehab clinic that’s in their network, where you know that they already offer coverage.
Eventually, coverage and policies will vary a lot depending on your plan. This means that you’ll always want to check your plan, what it covers, and who you can work with before moving forward, even if the addiction treatment center is in the Networks by Design network. Good luck getting treatment.
