Met an employee at an AA meeting one evening that happened to work for this program. They ironically told me through conversation that there had been a group of intake personnel that were committing insurance fraud but they had recently been fired from the facility….. A little background: I was sent to Able To Change through not only my insurance but the Inpatient facility I had just completed a program with. I was told by both (having had to personally call my insurance to confirm my benefits and coverage for Able To Change) I was approved for 100% coverage with $0 out of pocket through my insurance due to my benefits and them being an in network provider. Fast forward to my intake: I am told immediately by Chris (I think he’s the director?) after he LOOKED at my insurance card that I would not be covered. I especially would not be covered because I had been sober for 2 months already and because he has “been in this business for a long time and knows”. Without contacting my insurance he confirmed I was not covered and if I wanted to be in the IOP program I would have to pay out of pocket ($1000 a month for 3 night groups a week that are 3 hours or less). Let me just say that when I spoke to Chris next, he insisted I pay immediately. | I decided to confirm my benefits once more so I called my insurance to understand my coverage better since Chris didn’t have much to say about it besides “he just knows”. My insurance reassured and confirmed to me that Able To Change is in network and my benefits cover me 100%. I was confused why I would pay $1000 or any money out of pocket. I spoke to Chris again about this issue and he not only gave me some serious attitude- I wasn’t forking over money without a legit reason- but due to my questionable concerns not to pay that $1000 a month, he said verbatim “Well I guess it looks like you’re not going to be a good fit for us so I am discharging you.” I followed up with filing a formal complaint with my insurance which will go to the department of managed health care once I hear the outcome. I believe they don’t tell you the truth. They are committing fraud by telling you your insurance isn’t covered without even trying to contact them for coverage or benefits. | Where does that $1000 a month go?? Why $1000? Chris had mentioned I was getting a “good deal and it’s usually $2500 a month”. I mean there’s no explanation just a number and a charge… fishy…. if I can’t trust the care facility to be honest about my coverage… why would I pay them? Be wary It’s considered fraud to be an in network provider and charge out of pocket when benefits are 100% covered. “10 popular health care provider fraud schemes” article is a MUST read to confirm my fraud accusations: www.acfe.com/article.aspx?id=4294976280 No thanks to Able To Change and their claim to me being sober qualifies me as not Able to be covered, I am still sober. If you or someone you know needs help make sure you get the facts from your insurance before you pay any money out of pocket.
Name: Able To Change Recovery
Country: United States
City: San Juan Capistrano
Address: 31501 Rancho Viejo Rd Ste 101
Phone: (866) 225-3260