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FINANCIAL RESPONSIBILITY IN TREATMENT

We are committed to providing you with the best possible care and ensuring transparency in all aspects of your treatment experience, including the financial obligations. This Financial Responsibility in Treatment section of the patient handbook is intended to outline your responsibilities as a patient receiving treatment at our facility and to provide you with the necessary information you need to make informed decisions about the care you receive.

Service Level: The type and level of service you receive can impact your financial responsibility. For example, if you are admitted to an Acute Treatment Service (ATS) program , your fees may differ from someone who is in a Clinical Stabilization Service(CSS) program. Different services come with different service fees, and it is essential to be aware of these distinctions. Attached to this handbook you will find a fee of service rate sheet, that details estimated fee each service may cost you.

Length of Stay: The length of your stay can also affect your financial responsibility. Often times length of stay can be impacted by complex medical conditions/ your medical response to treatment, increased need for observation and monitoring, adequate discharge planning, or your personal preferences while in treatment. Longer stays generally incur higher fees; It's important to consider the potential financial implications when planning for your healthcare needs.

Insurance Plan: Your insurance plan plays a crucial role in determining your financial responsibilities. Understanding these aspects of your insurance plan is vital to managing your healthcare expenses.

• Medicaid (MassHealth): Medicaid is a joint federal and state program that provides healthcare coverage to low-income individuals and families. It is primarily funded by both federal and state governments, and the specific rules and eligibility criteria can vary from state to state. Medicaid is often considered a safety net program designed to assist those with limited financial means; If you are covered by a Medicaid insurance plan, will not be responsible for treatment-related expenses.

• Private Insurance: Private insurance is typically purchased by individuals or provided by employers. Private insurance plans are offered by private companies, and they come in various forms, including health maintenance organizations (HMOs), preferred provider organizations (PPOs), and more. If you are covered by a private insurance plan, you may be responsible for fixed costs associated with your annual deductible, and co-pay.

• Out-of-Network & Non-Contracted Health Plans: If you are seeking services and have an insurance policy that is Out of Network or Non-Contracted with High Point (HP), staff are required to contact your insurance company prior to receiving voluntary services to determine eligibility for behavioral health and substance use disorder treatment. If your health plan is willing to negotiate a “Single Case Agreement” with HP, the facility will agree upon a rate for all requested services for payment of treatment. In some instances, HP or the health plan may decline to enter into a Single Case Agreement arrangement for services. If a Single Case Agreement is unable to be obtained, the patient has the option to contact their health plan to seek an in-network provider for services or pay out of pocket for the identified serviced based on the fee estimate provided prior to receiving treatment. In the event you request to self-pay out of pocket for treatment services, you will be required to pay up front for a pre-determined amount of treatment or services. Section 35 Civil Commitment Services Only: In you are admitted under a Section 35 to treatment services with an Out of Network or Non-Contracted health plan, HP will contact your health plan to negotiate a Single Case Agreement for treatment services following your admission and during your inpatient stay. In the event that a Single Case Agreement is unable to be obtained, your services will be billed to the BSAS contract for payment. You may still be responsible for deductible or copay as outlined in your estimated costs.

Uninsured/Self-Pay Services: If you are seeking services and have been identified as being uninsured, under-insured or as self-pay, HP is required to provide you with a good faith estimate of your out-of-pocket cost for the identified treatment services. HP will assist you with determining if you are eligible for any financial assistance, including state contracts and sliding fee scales based upon your financial eligibility. Prior to receiving services, HP staff will provide you with financial determination paperwork to complete before receiving services and request income verification prior to receiving services. While the financial determination is in process, you will be required to pre-pay for services prior to admission for a set number of days, sessions or services based upon the program. Once the financial determination has been made, you will be notified of your good faith estimate. If you choose to discontinue services based upon the financial determination, HP will provide you with a list of resources and other community providers. Section 35 Civil Commitment Services Only: If you are admitted under a Section 35 to treatment services being identified as uninsured, under-insured or self-pay, staff will provide you with financial determination paperwork to complete while you are receiving services and request income verification to be provided. Once the financial determination has been made, you will be notified of your good faith estimate. Additionally, your services may be eligible for payment from the BSAS contract for Section 35 services.

Zero Violence Notice

High Point is committed to providing a “Culture of Safety” for our employees and those we serve. We will ensure that all employees, clients, and/or any other people who are either on our premises or have contact with employees in the course of their duties are aware we have “ZERO TOLERANCE” for any disruptive or aggressive behavior that may cause a reasonable person to be in fear of his/her or a colleague’s safety. Acts of violence or serious threats of violence can be made directly or indirectly toward an employee or his/her personal property.

 

The Occupational Safety and Health Act (OSHA) of 1970’s General Duty Clause requires that employers must furnish a place of employment which is free from recognized hazards that cause or are likely to cause death or serious physical harm to employees.

Workplace violence can be conducted through actions, intimidation, or threats made by any means. Threats may be conducted in person, be made verbally or non-verbally, by letter, telephone, electronically, or through social media; may be implied, made seriously or in jest by a current or previous client or employee, by someone known by a client or an employee, a visitor, or members of the community.

A ‘workplace’ is defined as any location away from an employee’s home, permanent or temporary, where an employee performs any work-related duty. This includes, but is not limited to, the buildings and surrounding perimeters, including parking lots, field locations, clients’ homes, and traveling to and from work assignments.

We are cognizant that there may be an inherent increased risk for acts of violence made toward employees servicing more acute client populations. High Point will make every effort through proper crisis prevention training and use of counseling techniques to decrease this type of behavior by using proven outcome measure counseling techniques such as Trauma Informed Care, Motivational Interviewing, and application of harm reduction protocols. Yet we recognize that some acts of violence may be unavoidable, due to a severe psychiatric diagnosis or other factors.

High Point prohibits any form of harassment, bullying, ostracizing, or discrimination due to race, color, religious creed, national origin, ancestry, age, disability, gender, sexual orientation, veteran status, and other protected categories under federal and/or state law, or for any other reason. Harassment and bullying may be defined as physical and/or psychological abuse that may impact an employee or a group of employees’ level of stress, their emotional well-being, their job performance, the overall effectiveness of the work unit, and the proper servicing of clients.

Harassment includes, but is not limited to, uninvited or unwarranted physical or sexual contact, remarks, gestures, behavior, and/or display or circulation of written and/or visual materials. Harassment may also include unwarranted exertion of power or coercion by another employee or supervisor. Bullying is any form of harassment initiated by more than one employee or by a group of employees.

Cyber harassment or bullying includes, but is not limited to, the use of technology or any electronic communication, which includes any transfer of signs, signals, writing, images, sounds, data, or intelligence of any nature transmitted in whole or in part by a wire, radio, electromagnetic, photo electronic, or photo optical system, including electronic mail, Internet communications, instant messaging, texting, blogging, or facsimile communications. It also includes assuming the identity of another employee and using social media to harass, bully, and/or threaten an employee.

Ignoring an individual who exhibits these behaviors sends the message that such behaviors are acceptable; consequently, the behaviors are likely to continue and may even increase, and they may be precursors to workplace violence.

Therefore, it is incumbent on all employees to identify and report these behaviors immediately, so that appropriate action may be taken. High Point has a “Duty to Warn” clause in Section 700 of the Employment Handbook, which states, “Employees are required to report to their immediate supervisor if there are any concerns that an employee is at risk for hurting him/herself or others.”

Employees must also follow the Human Resources Problem Resolution Procedure if they believe that previous reports of harassment, bullying, or serious threats have not been properly addressed, doing so without fear of retaliation for such reporting.