The Admission Process
Finding the right treatment program and the appropriate level of care can be overwhelming. Our admissions specialists are here to help determine the best level of care to fit your child’s clinical needs and determine if Hillside is the right place for your family. In order to help you in this process, our team will need to have information on the treatment history and clinical presentation from you and your child’s providers.
Step 1 – Complete the application for admissions
Once you have reached out to our admissions team, one of the admissions coordinators will send you the Getting Started email. You will have access to complete the application for admissions from this email. The application for admissions will help us understand your child’s struggles from the family’s perspective, the social history information, along with necessary information for verifying insurance benefits.
Step 2 - Submit clinical documentation
The treatment team at Hillside needs to see clinical documentation from a mental health professional that clearly outlines: diagnosis, current medications, historical information describing how the child’s symptoms began and have progressed, behaviors within the last 2-4 weeks that necessitate placement in higher levels of therapeutic treatment, and a description of interventions that have been tried to address the issues.
Step 3 - Documentation review
Once our admissions team receives the completed application for admission from the family and the clinical documentation from the current treating providers, our treatment team will review the information to determine if your child would be a good fit for Hillside’s program. This process usually takes 24-48 business hours.
Step 4 - Insurance authorization
If the child is approved for admission, the admissions team will then work with the child’s referring provider and insurance company to secure authorization for the treatment program recommended, and to schedule an admission date. It is during this time that the additional documents required for admission will be gathered.
Step 5 - Admission to Hillside
Once an admission date is scheduled, your admissions coordinator will email you consent forms to complete prior to admission. You will also receive additional documents and communication regarding program orientation to help you and your child prepare for admission to Hillside.
Please submit all documentation to email@example.com. You can find links to our admissions documents and frequently asked questions below.
Our Admissions Team
How long does the admission process take?
Once our admissions team receives the completed application for admission from you and the clinical referral from your current treating provider, the treatment team typically takes 24-48 business hours to approve an admission or recommend alternative treatments.
If your child has been approved to admit to one of Hillside’s programs, our team will work with you to schedule an admission date or give an estimate of when the next available space will be.
What about school?
Each of our programs offer different levels of academic support.
For Residential Treatment Program: Clients are enrolled into full-time school and attend classes on campus from 8 a.m. – 2 p.m. during the school year. Hillside’s Conant School is part of Atlanta Public Schools and is independently accredited through Cognia. (hyperlink Conant School to the school page).
For Experience DBT Day Program: Clients are usually on a hospital homebound agreement for academic work and are given approximately 8 hours during the week to work independently on school assignments.
For Virtual Intensive Outpatient Program: Most clients in Virtual IOP continue to attend school while participating in the program. Depending on the school schedule, some minor arrangement may need to be made to accommodate treatment. As the situation differs for each client, our treatment team will discuss how to manage school and treatment with each family prior to starting treatment.
For Intensive In-Home Therapy: Our therapists work around the client and family schedule. Most of our clients in Intensive In-Home Therapy continue to go to school and participate in treatment outside of school hours.
How do I know which program or level of care my child needs?
Reach out to our admissions team! Our admissions team members will be happy to help you navigate this treatment journey. We will ask you some questions to gain a better understanding of symptoms and history of treatment to help direct you to the appropriate Hillside program.
Your child’s current treating provider may also be a great resource for you and your family in recommending the appropriate level of care. Since your current treating provider is already familiar with your child’s clinical presentation, your provider can often give you a clinical recommendation to fit the clinical need.
How long will my child be in treatment?
Every child is different. The length of stay depends on factors such as your child’s clinical presentation, the treatment program curriculum, the goals for treatment, as well as aspects such as insurance funding or personal funding. Since most of Hillside’s clients are engaged in a more intensive level of care, our treatment team will recommend continued treatment at lower levels of care to maintain progress after leaving Hillside.
- Hillside Document Checklist
- Residential Admission Agreement & Consent for Treatment Packet
- Release of Treatment Information & Medical Records
- How to Request Medical Records
- Insurance Process
Financial Responsibility & Insurance Coverage
- Hillside Patient Financial Responsibility Policy
- Accepted Insurance Providers & Mental Health Coverage
- Insurance Process
Preparing For Your Stay
Health insurance can be difficult to understand as insurance coverage and/or providers often change on a yearly basis. If your employer has recently taken on a new provider through open-enrollment, you surely have questions about what’s covered.
Hillside is happy to provide helpful information regarding mental health services in relation to insurance providers and coverage. Below is a listing of mental health insurance providers that we regularly work with and offer some type of mental health insurance coverage.
However, if you do not see your provider on this list, please contact us. We are constantly credentialing with new plans both commercial and Medicaid plans.
Also if we are not in-network with your plan, we can always work with you as an out-of-network provider. We have been successful in getting plans to agree to a Single Case Agreement to treat your child for this one stay as in-network providers. If the client meets clinical necessity criteria and DBT treatment is indicated, most plans will agree to these Single Cases as we are currently the only Child and Adolescent Residential Program in the nation that has been recognized by the DBT Linehan Board of Certification as a Certified Program. We also work with families with private or self-pay situations.
Accepted Insurance Providers Offering Mental Health Coverage:
BCBS Blue Cross Blue Shield
Beacon Health Options (formerly “ValueOptions”)
Beacon Health Options – Georgia Collaborative ASO
Behavioral Health Solutions
CompCare/CBH Care – Comprehensive Behavioral Healthcare, Inc.
Concentra Insurance/Principle Edge Network
Core Solutions/Gulf Stream
Consumer Choice First Health
Friday Health Plan
HealthOne Alliance/Alliant Health
Humana/Humana One Health Plan of GA/Lifesynch – Humana Behavioral Health
Maestro Magellan Healthcare
Meritan MHNet/Coventry Health Care
MultiPlan, Beech Street/Viant
Tricare Humana Military Insurance/Tricare
United Healthcare / United Behavioral Health (UBH) / Optum
United Health One
Accepted Medicaid Insurance Providers Offering Mental Health Coverage:
- Amerigroup Georgia – GA Medicaid
- Beacon Health Options – Georgia Collaborative ASO
- Caresource – GA Medicaid
- Peach State/Cenpatico – GA Medicaid
Hillside is not in-network with Medicaid plans outside of the state of Georgia. However, Hillside can work with some out-of-state Medicaid clients through a single-case-agreement as their plans allow due to the specialized treatment Hillside offers.
Paying for Mental Health Care
Most Hillside clients utilize medical insurance to cover some or all of their treatment costs. Private pay for treatment can also be arranged if insurance coverage is not available.
Each insurance provider and Medicaid coverage varies by state and/or plan. It is best to consult with your insurance provider to fully understand the coverage for mental and behavioral health treatment. Each provider will typically outline their coverage benefits on their website. If their mental health coverage is not outlined clearly or you do not fully understand the coverage, we recommend calling and speaking to a representative. On the back of your card, there should be a phone number for behavioral health or mental health benefits. Our admissions team members are happy to assist with coverage questions as well.
Prior to admission to any of our programs, our Admissions Staff will check your benefits and determine your insurance coverage and the out-of-pocket expenses. Based on the information our team is given, the admissions team will review with you your financial responsibilities including copays, co-insurance, and deductibles. Your portion of financial responsibility will be due prior to services or mental health treatment is provided.
Understanding Health Insurance & What to Expect from Insurance Providers
While mental and behavioral health treatment are usually listed as covered a benefit, your insurance provider will authorize treatment based on the insurance company’s guidelines for medical necessity of treatment. Each covered service has to be pre-approved by your insurance company prior to delivery of services.
If your insurer authorizes admission to one of our programs, they will specify the number of days they will initially approve for treatment. Generally, they authorize a short period of time initially, which prompts a clinical review shortly after admission so that the insurance company’s care manager can obtain information about our assessment of the client’s condition and initial response to treatment. For example, Partial Hospitalization Programs (PHP) or Day Programs, insurers may authorize an initial period of 1-3 days and Residential Treatment, insurers often grant 5-7 days, sometimes more, sometimes less. At the end of this initial period, Hillside’s Utilization Management Department will review the client’s progress with the insurer to get continued coverage for treatment. This is called “concurrent review.”
If the insurer determines that the client meets their ‘medical necessity’ criteria for continued treatment, they will authorize coverage for an additional period of time. The review process will continue like this throughout the course treatment at Hillside. We encourage parents to understand their insurer’s definition of medical necessity and any requirements the insurer has around family participation in treatment.
We will keep you updated on your child’s progress and will be working with you to coordinate a smooth transition home with needed support services. The care manager from the insurance company is often a great resource in identifying additional community-based services to ensure a successful transition. At some point in the utilization review process, the insurer may determine that the client is no longer, or close to no longer, meeting their established criteria for the program. If this is the case we will notify you. If we believe that there is additional information that could change that determination, we will ask your insurer to schedule a peer review. During a peer review, the client’s psychiatrist at Hillside will review the client’s progress with the insurer’s psychiatrist. Based on this review, additional days may be authorized.
If additional days are not authorized, your insurer will deny payment for continued days of treatment at Hillside. Our clinical staff will notify you of the insurance denial and discuss the treatment team’s recommendations and whether an appeal of the decision is appropriate. If you wish to continue your child’s treatment at Hillside in spite of the insurance denial or during the appeal process, you will be referred to Admissions to discuss private-pay options.
If there is an appeal, the process may go through several levels. It may take two to three days for each level of appeal and up to 30 days for an independent review done by a psychiatrist independent of your insurer. Your insurer may or may not reconsider their denial. If the denial is overturned, the insurer will make payment for all the days previously denied and will specify how many more days of treatment will be authorized for payment. It is possible the denial will be upheld and the cost of continued care is the responsibility of the parent/legal guardian.
My Insurance Provider Isn’t Listed or Doesn’t Provide Coverage – What Else Can I Do?
Please feel free to reach out to our Admissions staff prior to treatment. If Hillside is not currently contracted as an in-network provider for your insurance, we may be able to discuss a single-case-agreement or work to become an in-network provider as we are constantly credentialing with new insurance plans.
If your insurance provider does not offer coverage, you have the right to challenge your insurer’s decision with your care manager. You can and should also express your concerns with your employer’s benefits office or human resources.
Help for Military Families
As of October 2018, Hillside is proud to be in-network and accept Tricare Humana Military Insurance. We are so pleased to open up opportunities for mental health services for military families and their children. Our partnership with Tricare means our military service members can find the therapeutic services for their children’s mental health needs.
Our location is perfect for families living near bases throughout the southeast, including:
- Fort Benning, Fort Gordon, Fort Stewart, Hunter Army Airfield, Naval Submarine Base Kings Bay and Robins Air Force Base in Georgia
- Redstone Arsenal Army Base, Fort Rucker and Maxwell Airforce Base in Alabama
- Multiple military facilities in Jacksonville, Florida
- Military establishments in close proximity to Beaufort, South Carolina
The expansion of Tricare’s benefits to dependents for medically and psychologically necessary mental health care means the children of military families can take advantage of Hillside’s programs.
Tricare Covered Services at Hillside
Our highly qualified team at Hillside is committed to supporting the mental health and well-being of Tricare beneficiaries. We are proud to serve America’s heroes and their families through our unparalleled programming and therapies.
Military families have unique stressors and needs. Being part of a military family means you not only have to handle the same difficulties that civilians face but also additional challenges that are unique to military life, such as:
- Adjusting to a service member’s deployment
- Frequent re-assignments and changing schools
- Irregular schedules or routines
- Living far away from family and friends
- Heightened security risks
- And more