Insurance Reimbursements: Clinicians Are the Key

Clinicians are incredibly important to a treatment center’s overall success. Good clinicians can truly make, or break a treatment facility. Your patient’s satisfaction depends in many ways on the efforts of your clinicians, as they are the ones providing the help and care. Additionally, clinicians play a central role in helping your treatment center get the correct insurance reimbursements.

Although your clinicians may be your strongest ally when working with people, they can potentially be harmful to your treatment center’s finances.

Addiction treatment is very expensive to say the least. The necessary care provision is very intensive and complicated. Although the ideals and principles behind care centers are very altruistic in nature, good intentions alone cannot sustain a business. At the end of the day somebody has to pay the rent, utilities, and wage costs associated with these centers.

The combination of the expensive treatment fees, and the likely economic instability of the patients, leaves us with a difficult question: Who is going to pay for the patient’s recovery? In many cases the answer is insurance companies.

For obvious reasons, insurance companies manage their funds very carefully. Although they are obligated to help in varying extents depending the situation, it is within their own interest to ensure that they do not pay any more than required. To ensure fairness in distribution of these funds, there are specific guidelines and prerequisites that are attached to these obligations, and if not met, they are under no obligation to pay.


Herein lies the danger: regardless of the reality of a patient’s needs, the funds provided by an insurance company are determined from your clinician’s notes and records.” (Stevens, Matt)


The only way to prove that patients qualify for higher insurance reimbursements is through the notes taken by clinicians that worked with them in their recovery

Imagine that as a treatment facility owner you have a clinician that is great at working with patients, and successful in helping them recover, but bad at note taking and other routine tasks involved in their day to day work. Would this be a clinician you want on your team? Although such a clinician has the potential to do a lot of good within the facility, if they do not make it a priority to help the center receive its merited insurance reimbursements, they will likely be a sizable liability to the center’s overall success.

Here at Alleva we designed our EMR with solutions to these issues in mind. Through innovations such as word minimums on all notes taken, medical term word banks, and deadline alert systems, clinicians will be guided to take their notes in such a way that the facility they work for can qualify for their appropriate share of insurance reimbursements.

Although the solutions are very simple, they have considerable value. When applied, these small changes will save any given treatment facility thousands of dollars in lost insurance reimbursements. But most importantly, they allow the center to focus on what really matters; the people under their care.



Stevens, Matt. “How to Clinician-Proof Your Treatment Center For an Audit.” Recovery Brands. Recovery Brands, 18 July 2017. Web. 22 July 2017.<>.