PATIENT INFORMATION
Financial Responsibility Policy
McLean Hospital accepts Medicare, Massachusetts Medicaid (substance abuse services
are limited to outpatient only), Blue Cross and many other private health insurance
plans. The hospital also has working arrangements with many managed care companies.
Most health insurance policies provide benefits for psychiatric services. However,
access to these benefits is often restricted or limited, particularly for certain
types of comprehensive care. In general, short-term inpatient, partial hospital,
and outpatient services are covered by insurance, while benefits for residential
and longer term care may be limited. Most insurance companies also require pre-certification
for inpatient and partial hospital services.
McLean's policy is that the individual accepting financial responsibility
for a patient's treatment is responsible for payment, and is expected
to keep the account current for self-pay balances.
We will work with patients and families concerning insurance coverage for treatment
at McLean. If you have any questions about the extent of coverage, we strongly
recommend that you contact your insurance carrier to determine potential benefits
available for treatment. The following information may be useful in answering
questions from insurance companies.
McLean Hospital is:
- A private, not-for-profit psychiatric hospital
- Licensed by the Massachusetts Department of Public Health and Department of Mental Health
- Fully accredited by the The Joint Commission
- Operated with internal medicine services but without surgical services,
but has transfer agreements with the Massachusetts General Hospital and other
nearby general hospitals.
It may be useful to inquire how insurance benefits cover room and care rates and physician or other professional fees, and the amount of any self-pay balances.
In some instances, particularly with managed care organizations, we may be able
to assist you concerning our contracts with insurance companies. For more information,
please call our Patient Financial Services representatives at 617-855-3316. Please provide us with any information concerning benefits that
you have been able to obtain from your insurance carrier – and a telephone
number so that we are able to obtain verification of benefits. Please have your
insurance card available when calling for information and always bring it to
the hospital.
We will work with patients and families prior to admission and throughout the
course of treatment to determine the most cost effective treatment that meets
clinical needs.
Rate reductions are available for some services for self-pay balances and treatment
provided on a private pay basis. In general, rate reductions may be available
for inpatient, partial hospital and outpatient treatment, but not for most of
our residential care programs. Rate reductions vary depending on financial need
and available resources.
