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.

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.

Insurance companies reimburse according to the following definitions of levels of care:

Partial Hospitalization (PHP): 5 services a day a minimum of 4 days/week
Intensive Outpatient Program (IOP): 3 services a day a minimum of 3 days/week
Outpatient Services less intense than PHP or IOP: billed individually

This is Yellowbrick’s fee schedule for levels of care:

Upon admission for initial 30 days, The Residence with Partial Hospitalization (PHP): $1475/day 7 days week plus CCN fees.
After the initial 30 days, The Residence with Partial Hospitalization (PHP):$1275/day, 7 days week plus CCN fees.
Partial Hospitalization, $1275/day, for initial 30 days of PHP, plus MD/APN & CCN fees
Partial Hospitalization, after initial 30 days, $1050/day plus MD/APN & CCN fees.
Intensive Outpatient Program (IOP), $725/day plus all additional individual Professional Services and MD/APN & CCN fees.
Specialty IOPs; $725/day; no additional charge if in PHP.
Outpatient individual Professional services billed as utilized.
Comprehensive Assessment $7950; included in fees for initial 30 days of PHP.
All levels of care are provided Case Management, 24/7 MD On-Call consultation, CCS Crisis & Support Services, Community Activities and Weekend Program.
Overnight crisis support at The Residence $375; option in lieu of ER and hospitalization.
Attending unscheduled groups beyond the Treatment Services Agreement will result in being billed for PHP; $1050.

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.
Professional Service and CCN 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.

At Yellowbrick, emerging adults find their way home.

For more information, please contact Yellowbrick at 847-869-1500.