Other Parents Like Me Membership:
All Cornerstones of Maine Parents receive a free Other Parents Like Me (OPLM) subscription while their child is enrolled in our program. For more information on OPLM, please download this brochure.
Parents have unlimited access to:
SJ Health Insurance Advocates Partnership:
Cornerstones of Maine is a private pay transitional living program, but we do offer insurance liaison assistance upon request with the help of SJ Health Insurance Advocates. Below is information about our partnership with SJHIA and how parents can utilize their services to potentially receive insurance reimbursement. Please note: reimbursement is not guaranteed.
Who is SJ Health Insurance Advocates?
SJ Health Insurance Advocates, LLC (SJHIA) is a New Jersey-based company that specializes in behavioral health insurance authorization and claims management. Cornerstones of Maine provides the option of utilizing insurance services through SJHIA to help patients obtain reimbursement for treatment. You may visit their website at www.sjhia.com to learn more. Cornerstones of Maine will provide all required information to SJHIA to utilize insurance benefits. In turn, SJHIA will verify and communicate to the patient information such as whether the patient has coverage for treatment, whether such coverage includes out-of-network providers, plan deductible, and out-of-pocket limits.
Will SJHIA answer my questions about insurance benefits and authorizations?
We strongly encourage you to contact SJHIA before enrollment to discuss your specific insurance coverage. A consultation with SJHIA will provide answers to the many questions that arise regarding insurance benefits, along with advice on what approach will best serve you. To contact SJHIA, please call: (973) 740-0023 ext 122 or email firstname.lastname@example.org. Tell them that you are calling about Cornerstones of Maine.
What level of care will SJHIA submit claims for?
SJHIA will file claims for the therapeutic component of the program at Cornerstones of Maine which the insurance industry recognizes as reimbursable expenses. This includes group therapy, family therapy, and individual therapy. Before the initial claim submission, SJHIA will contact your insurance carrier to obtain authorization to file for such claims if needed.
When can I expect to receive payment for services?
Cornerstones of Maine is an out-of-network provider. As such, claims can take approximately 45 – 60 days to process, with often a longer turnaround time for the first set of claims submitted. It is also important to note that insurance companies may request additional information from SJHIA and Cornerstones of Maine before processing claims. This may include requesting medical records for review. This process may result in a delayed processing time and/or a decision to not pay out the claim. If this is the case, SJHIA will communicate that information to you.
Is there a way to determine how much money I will receive back if claims are approved?
SJHIA can provide some guidance around your reimbursement based upon your specific policy and the typically allowed amounts. Please feel free to reach out to SJHIA to discuss your individual case.
Is there a fee for services rendered by SJ Health Insurance Advocates?
Yes, SJHIA charges a 10% contingency fee based on paid claims. If treatment is not authorized and/or claims do not pay, then there is no fee.