Sandstone Care Reviews (%countItem)
Sandstone Care Rating
Address: 11820 Parklawn Dr, North Bethesda, Maryland, United States, 20852
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I contacted Sandstone Recovery in December of 2019 regarding substance abuse treatment. I spoke with admissions and provided them with my *** insurance information which would be effective Jan. 1, 2020. After running my insurance, I was told that Sandstone Care was in network for my insurance carrier. I worked with Meg W at Sandstone thereafter, and she made arrangements for my son to start Jan. 6. On Friday, Jan. 3, I called *** to make sure everything was authorized and I happened to double check that they were an in network provider. They informed me that they were not, and that my son's treatment would be subject to out of network benefits. I took Sandstone's word back in December that my insurance was in network. That was my mistake. I immediately called Sandstone and spoke with Meg W. I informed her that my son would not be able to start on Monday, due to it not being affordable for us to go out of network. She told me she would have someone from the insurance team call me, because they could often get a single case agreement with the insurance company to process the claim as in network. A man from the insurance department called me and let me know that they would send the information over to *** to get a single case agreement. He said he could not be 100% sure it would be approved, but in cases of children, it was close to 99%. We accepted this information and my son began the program the following Monday. I have since called *** 4 times to check on the status of the single case agreement and they have not received anything on this. I have personally spoken with the team insurance lead, Walter B, at least 4-5 times, and he continues to say that he sent it over. I have attempted to follow up with him by phone and email, and he no longer responds. This program costs $2300 per day for PHP, which my son participated in for 5 days. I'm unsure of the cost for the IOP for the second week, since I haven't received the insurance EOB.
Date: Tue, Mar 24, 2020 at 12:05 AMSubject: complaint ***To: ***@myRevdex.com.org <***@myRevdex.com.org>***, Sandstone Care and the *** Family have resolved any dispute and find the matter to be closed. The *** family asked that you email them directly to confirm their desire to rescind their complaint (email: ). As you can imagine, working with insurance companies is quite complicated and can be difficult for families that we serve to fully understand how coverage, authorization, and reimbursement works, especially with the added complexities that exist with in network or out of network plans. In addition, this case was further complicated by the family’s plan being out of network with our organization, and our goal was to support the family seeking a single case agreement to help increase accessibility if granted as it allows us to provide the services as an in network provider. Typically single case agreement are fairly routine for us to be grated as there are very limited alternative providers in the greater Washington DC area that provide the services we do. Unfortunately in this particular case, the families plan turned out to have a policy exclusion for single case agreements, which is very uncommon for us to see and something that the insurance company did not disclose to Sandstone Care until many weeks of advocating (no less than 5 phone discussions with them before it was disclosed). During this time, there were communication breakdowns with our Insurance Advocate team, however we have worked as diligently as possible to follow up with the family and provide as much support as possible to work through these challenges. The lack of insight to the policy exclusion created a loop in workflow that made communication difficult. Sandstone has reestablished good relations with the *** family and identified the failure in work flow and made appropriate adjustments to prevent future recurrence. Please let me know if you need anything further
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID, and find that this resolution is satisfactory to me.
Regards