“I wish I knew you a year ago”
The Wrong Rehab: How To Avoid Getting Ripped-Off
Know the signs
“I wish I knew you a year ago.” I can’t tell you how often I hear that from families who get ripped-off by a rehab that, “looked good on Google” but realized too late that they’ve been had by a “rehab” that promised them “total recovery” for their son.
Several years ago, I met with one family in my conference room — nine of them came for the meeting. I well remember one of the adult male members asking, “All I have to do is Google ‘rehabs,’ and I see hundreds of them out there. Why are we hiring you?”
“Actually, there’s more than sixteen thousand of them out there,” I replied. “Can you tell me which is the right one for your nephew?” Awkward pause, then, “Good point,” he said.
As of 2022, out of the over 25,000 that call themselves treatment centers or “rehabs”, the Substance Abuse and Mental Health Services Administration (SAMHSA) surveyed 21,160 of them.¹ All you have to do is pick the right one for you or your loved one. Easy, right? The point is, if you’ve never done this before and know nothing about rehabs, how do you do that?
That is precisely why I do what I do and wrote a book as a guide for families in crisis due to addiction and/or mental illness and they have no idea what to do.
Some of the stories clients tell me about their experiences with unethical facilities before they came to me are true nightmares. Michael, who stayed in a sober living house for seven months in southern California, had one outpatient group session per week, (not three as promised), plus the facility managed to wrangle $90,000 out of his insurance company for three-a-week bogus and overpriced drug testing.
Then there’s David, whose wife went to alcohol treatment at a facility in southern Florida. Although he was promised that his upfront $6,700 payment, plus insurance benefits, would cover the entire thirty days of treatment, it didn’t stop them from hitting him with a $15,000 bill upon her return home. The rehab claimed that her insurance company’s payments didn’t come close to covering their billing rate and other costs, so they billed him for the balance. Welcome to “balance-billing,” where rehabs set their own pricing, and when the insurance company doesn’t meet that arbitrary price, they pass along to you the “balance of what they are owed.” Oh, and despite their promise to David that they are in-network with their insurance company, they weren’t.
The point is, the mental health and addiction treatment centers market size in 2022 was $138.4 billion² and like so many other business sectors even close to being that large, there are going to be charlatans and scammers. What’s particularly pernicious, venomous, worthy of burning at the stake (really, I’m serious) are the scum who prey upon the vulnerabilities of uninitiated, terrified families hit by addiction just to make a quick buck.
Anytime you are told by a treatment facility — either by a cold call from a call center or on the other end of a toll-free number flashing on your late-night TV screen — that they are the right facility since they treat everything, hang up and block their number. No such rehab exists on this planet. Period.
One Size Does Not Fit All
In the simplest of definitions, formal treatment at a reputable facility typically incorporates a combination of detox, behavioral therapies, and medications; the facility should then structure an aftercare plan or — recovery support services (RSS) — when the individual is transitioning into “the real world.” However, no one treatment facility or one single treatment is “the right one” for every individual and disorder.
Understanding each person’s unique physical, psychological, and behavioral needs, the intensity and nature of their SUD, including their resources in order to pay for treatment, lead to outlining a year-long treatment plan that determines the intensity and composition of the first ninety days of formal treatment followed by an aftercare program.
The key is finding the right rehab for each individual. It’s one thing to have someone tell you, “Hey, you oughta send her to (name of a facility), I hear it’s great.” but how do you know is it the right one for that particular person? You don’t. And the one telling you that certainly has no clue. For that, you’ve got to get into the details of the individual’s diagnosis and several factors particular to that patient, then match that patient’s diagnosis with the facility’s licensure, plus those factors that best fits his or her profile.
Factors include the following:
● DOC: Drug(s) of choice
● Co-occurring disorder (if one is diagnosed)
● Drug-related and other medical issues
● Goals and milestones (and steps to achieve them)
● Age, race and ethnicity
● Sexual orientation
● Gender identity
● Economic and social status
● Vocation
● Language
● Health literacy
● Legal problems
● Financial and/or insurance resources
Avoid the Following
In order to make the optimum choice for you or your loved one, let’s start with scenarios and facilities that you should avoid:
➔ TV commercials that direct you to call a toll-free number. Your call actually goes to a call center packed with “treatment specialists” desperately trying to close sales with people just like you. They are not treatment specialists; they’re sales representatives reading from a script peddling as many open beds as possible. And if you call back and wish to speak with the same representative again, good luck — the chances of you speaking with the same representative again are nil.
➔ Body brokering. A “treatment specialist” pumps you for insurance, financial, and extremely personal information that is going into their database. With that “assessment,” they then auction your treatment to one or more rehabs in return for a referral fee, but they don’t tell you that. Their service is tempting at first since it is free of charge to you. However, you don’t know whether the company is recommending a specific rehab because it is the best treatment for you or your loved one or because it is the one paying the highest commission. This “body-brokering” approach is dishonest and unethical, and in some states, it’s illegal.
➔ Aggressive sales representatives who offer to pay for your flight — one way, of course.
➔ Facilities that say they accept your insurance. Confirm it. What they often don’t tell you is whether they are an in-network or out-of-network facility. “Out-of-network” means that the deductible, out-of-pocket maximum and treatment reimbursement rates are higher in the rehab’s favor — frequently double what they would be at an in-network facility. Plus, instead of asking for those fees upfront — which is normal practice at ethical facilities — frequently they squeeze you for them later when you are already in treatment, causing you to panic that you’ll be kicked out unless you come up with the cash. If you don’t have it, they either kick you out or bill you, making you legally liable for the fees. And it doesn’t end there. Some of these outfits actually sic a collection agency after you and ruin your credit along with it. I can tell you horror stories of victims with less than thirty days of treatment who have been escorted off the rehab property when their insurance company stops authorizing payments and they didn’t have the ability to pay cash for the rest of their treatment. Ethical rehabs don’t do that.
➔ Rehabs that won’t confirm the costs quoted to you over the phone via e-mail or fax.
➔ Facilities that don’t disclose additional fees they charge separately for sessions with a psychiatrist or a physician, medications, local transportation and housing fees when stepped down to PHP.
➔ A facility unknown to long-time treatment professionals.
➔ Rehabs that are not certified by CARF International (the Commission on Accreditation of Rehabilitation Facilities) or the Joint Commission. Both are accreditors of health care service providers (i.e.: hospitals, rehabs). Between the two, they certify more than twenty-eight thousand providers domestically and worldwide.
➔ Rehabs that are not members of the National Association of Addiction Treatment Providers (NAATP), the ultimate umpire of ethical treatment practices. If a facility violates NAATP’s code of ethics, they’re called out and possibly expelled
➔ Be wary of those owned by equity or hedge funds. Most of them are in it for the return on their investment, not optimum treatment for the individual.
➔ A rehab that recently changed its name and corporate identity. That could be a sign that the facility has been sued, went bankrupt, or abruptly changed ownership for a suspicious reason.
Now that you’ve been warned about how to stay away from the scammers masquerading as true rehabs, next you’ll see what questions to ask a rehab that wants your business.
Walter Wolf is the pen name of a 30-year veteran of the movie and television industry who produced studio and independent films and television throughout the United States, Australia, and South Africa. That all changed in 2010 with one 3 A.M. call that a family member was in crisis due to addiction. Today, he is an interventionist who matches adults and adolescents with the optimum treatment program and facility for their particular diagnosis, demographics, financial and personal needs. In order to demystify and explain in layman terms what treatment is and how to get it, Wolf wrote The Right Rehab which became the only step-by-step guide for vulnerable families navigating the confusing world of addiction and mental disorder treatment, health insurance and recovery.
Footnotes
¹Substance Abuse and Mental Health Services Administration (SAMHSA) 2023. National Substance Use and Mental Health Services Survey (N-SUMHSS) 2022: Data on Substance Use and Mental Health Treatment Facilities. https://www.samhsa.gov/
²Grand View Research. https://www.grandviewresearch.com/
