EP 106: Maximizing OON Reimbursement on Self-funded Plans with Ali Beheshti

EP 109: Leading One of the Most Successful Non-profits in the Country with Jay Crosson

Cumberland Heights is one of the most consistently profitable non-profit treatment programs in the country. If you look at the 990s of many well-known non-profit treatment programs, they have consistent annual fiscal deficits when donor contributions are removed from the P&L. They have also continued to successfully expand throughout the state, adding on service lines and locations. In this episode, I speak with CEO Jay Crosson to learn just what it is about Cumberland Heights' strategy that has made is so consistently successful.

EP 108: Thinking Through Innovation in SUD with Brad Sorte

How do treatment programs innovate and what innovations are on the horizon, especially as we move into more consistent use of AI across departments? In this episode, I speak with Brad Sorte, previous CEO of Caron and current Co-founder of Sober Companion AI to address these topics.

EP 107: Opportunities in Teen Treatment Models with Chris Perkins

Teen treatment has been a hot topic for expansion and investment recently in behavioral health. "Lots of demand with not enough providers" is the current mantra. But is this accurate? What makes a good teen health provider? Should adult programs add on teen options? If the prevailing mantra is true, why are we seeing so many closures of teen facilities across the country? All these questions and more will be answered with my guest, Chris Perkins, CEO of Velocity Health Group and previous CEO of Calo (now part of Embark), one of the most successful teen treatment programs in the country.

EP 106: Maximizing OON Reimbursement on Self-funded Plans with Ali Beheshti

Many OON providers don't realize that a number of employer-funded insurance contracts include clauses that provide for higher reimbursements in exchange for guarantees not to balance bill patients, often resulting in millions of dollars of unreimbursed care. This episode is a deep dive into the complex world of third-party administrators (TPAs), downline administrators, self-funded vs. provider-funded insurance plans, and negotiating no balance billing clauses for OON contracts with Ali Beheshti, CEO of Zealie.

EP 105: How to Cultivate Private Pay Referrals with Mark OConnor.mp3

High-end private pay programs charge as much as $100,000 a month for patients entering these exclusive facilities. Cultivating referral relationships for patients in the income bracket that can afford such programs require a specialized approach. Mark O'Connor has worked in outreach for both Caron and The Lighthouse, two programs renowned for the quality of care they provide, that comes at significant cost for their higher end programming. Mark walks us through his relationships and approach that have helped him regularly place patients into such programming.