Financial Information for Parents

Facing Facts About Finances

Yellowbrick appreciates the level of financial commitment required of families to secure world class psychiatric care and personalized customer service. The costs of treatment are best viewed through the lens of weighing the costs of treatment against the costs of persistent risks and disability. Treatment at Yellowbrick is intensive and customized, based on research demonstrating a lifetime trajectory of improved outcome with this approach.
Individuals whose psychiatric condition has persisted for several years, and/or created safety risks and/or a period of incapacity to function, have better outcomes with a more extended support platform and continued intensive treatment, at varying levels of care, to sustain an enduring recovery. While no program can guarantee outcome, and the concept of cure has limited application to any chronic medical condition, Yellowbrick is “all in” with commitment to bring value to the family’s investment in treatment.

Yellowbrick is private pay, which means that families pay Yellowbrick directly and subsequently seek insurance reimbursement. Yellowbrick’s financial model is required due to the fact that insurance companies reimburse at rates and within timeframes which do not allow for delivering the integrated range and intensity of care at the level of expertise likely to have enduring effectiveness. We are glad to talk with you further about this and to support your efforts to seek insurance reimbursement. Additonal resources are available at www.covermmentalhealth.org.

Most people have the understandable expectation that because they pay their insurance premiums the treatment will be mostly covered by insurance. This is simply not the case. In fact, insurance companies often present hurdles in securing reimbursement, which creates further stress for families. While Yellowbrick will support families that choose to deal with insurance directly, we also offer the resource of a company that helps families fight for their rightful contractual benefits. Details can be found in the SJ Health Resources attachment to the Guarantors Agreement.

The following options are available for levels of care:

Assessment, The Residence, Partial Hospitalization (PHP) Full Programming, Crisis & Community Services: $1550/day, 7 days/week for the initial 30 days. Reduced to $1350/day after 30 days. Professional Services other than Synchrony Brain Health are included. Synchrony Brain Health fees additional and in-network.
Assessment, Partial Hospitalization (PHP) Full Programming, Crisis & Community Services: $1350/day, 5 days week, for the initial 30 days. After 30 days, $1150/day. Additional Synchrony Brain Health fees are in-network. Home visits are private pay.
Intensive Outpatient Program (IOP – 3 services a day), Weekend Program, Crisis & Community Services: $775/day plus all additional individual Professional Services not included in IOP. Synchrony Brain Health fees additional and in-network.
Up to 6 groups/week, Weekend Program, Crisis & Community Services: $1795/week plus all Professional Services. and Synchrony Brain Health services additional and in-network.
Specialty IOPs: $775/day (assumes no other groups that day).
All levels of care are provided Case Management, 24/7 MD On-Call Crisis & CCS Crisis & Support Services, Community Activities and Weekend Program.
Overnight support at The Residence: $375 (for those living outside The Residence).
Attending unscheduled groups beyond the Treatment Services Agreement will result in being billed for PHP: $1195/day.

Billing issues to be aware of:

Cynthia Navas, Director of Business Services, is the only Yellowbrick staff member with singular, exclusive authority to modify financial arrangements.
The Treatment Services Agreement is the official financial document outlining the current Level of Care and Professional Services with associated fees.
Decisions about Level of Care and Professional Services are best made collaboratively within Family Rounds. No changes to the treatment plan agreed upon with Professional Staff go into effect until the following Monday. A revised Treatment Services Agreement must be signed by the Guarantor for the changes to go into effect.
PHP/IOP fees are billed and paid in advance for the next 30 days and brought into alignment with the beginning of the month. Fees do not vary as a function of attendance.
Weekend days are not reimbursable by insurance.
Professional Service and Synchrony Brain Health fees are billed retrospectively for the prior month. Appointments not cancelled with a 48-hour notice are billed.
Bills are to be paid within 10 days of receipt by email.
Unpaid balances remaining after 10 days are subject to being charged on your credit card with a 2.5% service fee.
There is no time off from treatment without charges within the first 12 weeks of treatment.

Third Party/Insurance Reimbursement
Yellowbrick will not bill any insurance company or other third-party payor for Basic Services or receive payment from them. Yellowbrick will provide Patient and Guarantor with an itemized statement which may then be submitted to Patient or Guarantor’s insurance company for direct reimbursement by Patient or Guarantor. Please note the fees do not vary as a function of Patient’s attendance to program activities, however insurance reimbursement does vary on the basis of attendance.
If attendance does not meet the threshold criteria for which care has been authorized (e.g., PHP or IOP), reimbursement for program services will be denied for that day. Individual professional services may still be reimbursed. Families are strongly encouraged to discuss this with their adolescents and emerging adults.

Yellowbrick relies on transparency, communication and collaboration as essential within relationships with patients and families. We welcome your questions and discussion of your concerns about billing, the financial impact of treatment or any other issues where Yellowbrick can be of support.

Yellowbrick recognizes the financial strains associated with parents’ support of their emerging adult’s treatment. We encourage parents to discuss their individual circumstances and available options with Cynthia Navas, Director of Business Services (cnavas@yellowbrickprogram.com) available by phone at 847-869-1500 x 222.

Facing Facts about Finances

Does Yellowbrick take my insurance?
Yellowbrick is a private pay facility. Yellowbrick is not contracted with any insurance companies. This does not mean that you will not receive benefits but rather that benefits will be rated for out-of-network providers. Insurance companies do not pay for room and board or support services at The Residence. Based on the specifics of your insurance policy, insurers will pay what they arbitrarily determine to be “usual and customary” charges for Partial Hospitalization Program (PHP) and Intensive Outpatient Program (IOP). They will also unilaterally determine the length of time that they will authorize PHP or IOP treatment. Yellowbrick is private pay because the typical insurance reimbursement amounts and length of authorization for PHP/IOP do not support the comprehensive, intensive, and expert services provided at Yellowbrick. Neuroscience technology services such as deep Transcranial Magnetic Stimulation (dTMS) and neurofeedback are provided to Yellowbrick patients within our sister practice organization Synchrony Brain Health. Synchrony is in-network with multiple insurance plans. Please check with Yellowbrick’s Director of Business Services (847 869-1500 ext. 222) regarding the specifics of your insurance coverage and Yellowbrick’s fee schedule.

Does Yellowbrick bill my insurance?
Yellowbrick does not bill insurance companies. You will receive from Yellowbrick an invoice that can be submitted to insurance. If you need assistance with this process you can contract with SJ Health Insurance Advocates, an agency that handles all facets of the insurance billing and claims process.

Yellowbrick encourages all patients, families and/or guarantors to directly contact their insurance company to learn about specific benefit coverage and criteria for medical necessity prior to initiating an assessment or treatment. Insurance companies do not reimburse for individual or group sessions which are not attended. Parents are encouraged to discuss with their emerging adult that unattended sessions are not reimbursed by insurance and must be paid for by the family. Therefore, full participation in treatment is expected.

Insurance companies determine eligibility for assessment and treatment based on medical necessity. It is imperative that the patient, family, and/or guarantor, are aware of the criteria applied by your insurance plan. Establishing medical necessity is a prerequisite for accessing your benefits and authorization of your assessment and/or treatment. Even under stress or time constraints, it is extremely important to make yourself aware of benefit limitations and any other requirements your insurance company may have.

You may consider requesting that your referring clinician attempt preauthorization prior to your admission. You will receive a monthly invoice for services from Yellowbrick. There are administrative fees for subsequent requests for additional invoices and for copies of medical records.

If your insurance company denies care, Yellowbrick’s staff psychiatrist will participate in an expedited physician peer review. If your insurance company denies authorization of care after the physician peer review, we will, upon your request, continue to support you through further appeals by sending your completed medical record for a standard appeal after discharge. For results of appeals and status updates, we encourage you to contact your insurance company directly. We are not notified of post-discharge appeal results nor do we track or follow the post-discharge appeals process. It is the responsibility of the patient, family and/or guarantor to pursue any subsequent appeals options offered by your insurance company once we have submitted your entire medical record for a standard appeal the following discharge.

Finally, based on past experience, it is common for authorization and claims reimbursement from insurance companies to be a lengthy process. We are happy to provide the clinical information and documentation required by your insurance company as outlined above. Yellowbrick requires payment in full at the initiation of the assessment or admission into any of Yellowbrick’s programs.

Take the Next Step

Yellowbrick collaborates with adolescents and emerging adults, ages 16-30's, their families and participating professionals toward the development and implementation of a strategic “Life Plan.” An integrative, multi-specialty consultation clarifies strengths, limitations, and risks, and defines motivations, goals and choices.