Financial Policies & Good Faith Estimates
At New Harbor Behavioral Healthcare, we are committed to transparency regarding the cost of care and helping families understand their insurance coverage before treatment begins. Our team works closely with families to review benefits, discuss financial responsibility, and answer any questions about billing or insurance.
Insurance Verification
Prior to admission, our admissions team verifies insurance eligibility and behavioral health benefits directly with your insurance provider. Because New Harbor serves adolescents and young adults, this process typically involves communication with a parent or guardian.
Insurance verification helps us determine:
- Whether your insurance plan includes behavioral health benefits
- Coverage for services such as Partial Hospitalization (PHP) or Intensive Outpatient (IOP)
- Copayments, coinsurance, and deductibles
- Authorization requirements
Out-of-Network Billing
Depending on your insurance plan, New Harbor may be considered in-network or out-of-network for behavioral health services.
If New Harbor is out-of-network with your insurance plan, your insurance company may reimburse a portion of the cost of treatment based on your out-of-network benefits. In these cases:
- New Harbor may bill the insurance company as a courtesy to the family when possible.
- The insurance company determines the amount it will reimburse.
- Families will be responsible for the deductible, copayments, and/or co-insurance, and may be responsible for other charges that would be disclosed prior admission.
Our admissions team will discuss potential out-of-network coverage and estimated financial responsibility with families prior to admission whenever possible.
Because insurance plans vary widely, reimbursement amounts and patient responsibility are ultimately determined by the insurance company.
We are currently in-network with Point32 (Harvard Pilgrim and Tufts Commercial), and the Modern Assistance Program.
New Harbor is Joint Commission accredited and licensed by Massachusetts Department of Public Health to provide mental health and substance use treatment.
Authorization and Medical Necessity
Many insurance plans require prior authorization or ongoing utilization review for services such as Partial Hospitalization or Intensive Outpatient treatment.
Authorization decisions are made by the insurance company and are based on their determination of medical necessity. Medical necessity criteria vary between insurance plans and may change during the course of treatment.
While New Harbor works closely with insurance companies to request authorization and submit clinical information when required, we cannot guarantee insurance approval or continued authorization of services.
Families are responsible for:
- Understanding their insurance benefits
- Any costs associated with services that are not authorized or covered by their insurance plan
- Deductibles, copayments, coinsurance, or other plan responsibilities
Our clinical and admissions teams will communicate with families if insurance authorization changes during treatment so that appropriate decisions about care can be made.
Your Rights and Protections Against Surprise Medical Bills
When you receive emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, federal law protects you from certain types of unexpected medical bills. This protection is part of the No Surprises Act.
What is “balance billing”?
When you see a provider or facility that is not in your health plan’s network, the provider may bill you for the difference between the provider’s charge and the amount your health plan pays. This is called balance billing.
Federal law protects patients from balance billing in certain situations, including emergency services and certain services provided at in-network hospitals or ambulatory surgical centers.
New Harbor provides scheduled outpatient behavioral health services, and families typically have the opportunity to understand insurance coverage and financial responsibility prior to treatment beginning. Our admissions team reviews benefits and discusses any anticipated out-of-pocket costs before services are provided whenever possible.
If you believe you have been incorrectly billed, you may contact the federal No Surprises Help Desk at:
1-800-985-3059 or visit: https://www.cms.gov/nosurprises
Good Faith Estimates for Uninsured or Self-Pay Patients
Under federal law, patients who do not have insurance or who choose not to use their insurance have the right to receive a Good Faith Estimate explaining how much their medical care is expected to cost.
A Good Faith Estimate includes a reasonable estimate of the expected charges for services based on the information known at the time the estimate is created.
You have the right to receive a Good Faith Estimate if you:
- Do not have insurance, or
- Choose not to use your insurance for services
If you receive a bill that is at least $400 more than your Good Faith Estimate, you may dispute the bill.
Good Faith Estimates are typically provided:
- After services are scheduled, or
- Upon request prior to the start of treatment
To request a Good Faith Estimate for services at New Harbor, please contact our admissions team using the information below.
New Harbor Behavioral Healthcare
If you have questions about insurance coverage, billing, or Good Faith Estimates, our team is here to help.
Our team is available to discuss insurance benefits, financial policies, and treatment options to help families make informed decisions about care.