Open Sky Wilderness Therapy is a private-pay treatment center, meaning we are not affiliated with any in-network providers and do not process insurance payments directly. However, many families have successfully secured reimbursement for our services through their insurance plans. Further information on how to maximize your insurance benefits is provided below.
While Open Sky is a private-pay treatment center, we are partnered with leading insurance advocates to help families navigate the complexities of managed healthcare and to support families in receiving the maximum insurance reimbursement to which they are entitled. During the application process, all families are encouraged to research potential insurance advocates and contact them for free initial consultations about their insurance coverage. The initial consultation can provide answers to the many questions that arise regarding insurance benefits, as well as guidance on the approach to best serve your family. Regardless of whether you end up entering into a contract for services with a particular insurance advocate, a free initial consultation with one can provide some important information, including:
- verification of your plan’s benefits,
- whether or not your plan provides coverage for treatment,
- whether or not your coverage includes out-of-network providers,
- your plan’s deductible,
- your plan’s out-of-pocket limits, and
- guidance on recommended approach.
Depending on your plan’s allowable coverage, you may be reimbursed for a portion of to all program costs. The verification of benefits will determine if the insurance company allows Open Sky to be authorized and billed as residential treatment or for the specific services rendered, such as individual and group therapy.
If approved for residential treatment, up to 100% of program costs may be reimbursed. Please be aware, however, that this is less common and only applies when we are operating from our Colorado course area. If approved for the specific services rendered by Open Sky, our depth of services and respective superbill provides the basis to be reimbursed for between 20% to 40% of program costs. Final reimbursement amounts depend on allowable rates and coverages determined by your insurance provider.
Should you contract with an insurance advocate for their services, they are responsible for obtaining insurance authorization and managing the claims process, including coding, claim creation, electronic claim submission, corrections, appeals, and denials. Families who attempt to process claims on their own typically struggle with the process. We strongly recommend that you work with an insurance advocate to navigate the nuances of your insurance plan and the claims process. Open Sky will provide you with more information about these services during the admissions process. Typically, once a student’s application is approved, families connect with insurance advocates to perform their verification of benefits. If you have any questions, please contact our admissions team.