Insurance and Financial Responsibility
We encourage all patients, families and/or guarantors to directly contact their insurance company to learn about specific benefit coverage and criteria for medical necessity prior to admission.
Insurance companies determine eligibility for behavioral health treatment based on medical necessity. It is imperative that the patient, family and/or guarantor are aware of the criteria applied by your insurance plan. Knowledge of your insurance plan’s specific criteria will assist you in determining possible benefits available under your plan.
A limited number of insurers contract with Menninger for inpatient stabilization services. However, for the majority of our patients, insurance coverage is out of network, but ad hoc or single case agreements are the exception.
Even under stress or time constraints, it is extremely important to make yourself aware of benefit limitations and any other requirements your insurance company may have. Preauthorization with your insurance company before admission cannot be completed by Menninger because our physicians are unable to fully assess the patient until completion of the psychiatric evaluation. You may consider requesting that your referring clinician attempt preauthorization before the patient’s arrival at Menninger.
The following information may be helpful when talking with your insurance company. The Menninger Clinic is:
- A licensed private, not-for-profit psychiatric hospital offering specialty services
- Accredited by The Joint Commission
- Operated without on-site surgical facilities. Menninger has transfer agreements with local medical hospitals.
For individuals who don’t have preauthorization from an insurer before admission, within one business day of the psychiatric evaluation by a Menninger physician our Utilization Review staff will request authorization of the patient’s care here. When authorization is confirmed, we will review the medical record to ensure the information supporting the need for psychiatric inpatient care is documented for your claims or appeals. Menninger charges a bundled daily rate and doesn’t itemize individual service and medication charges. Utilization Review staff will provide regular updates to the insurance company to request authorization for continued inpatient care. If requested by the insurance company, our physician will participate in a peer review to determine continued authorization. Note—expedited reviews are different for each plan.
If the insurer denies authorization after the physician peer review, Menninger will, upon your request, continue to support you through further appeals by sending your completed medical record for a standard appeal after discharge. For results of appeals and status updates, you must directly contact your insurer since Menninger doesn’t receive the results of appeals. In working with our patients and families, we have learned that it is common for authorization and claims reimbursements from insurance companies to be a lengthy process.
Payment of services
Before admission, the Access Center/Admissions representative will work with you to develop a payment contract for services that Menninger provides. The guarantor is responsible for paying for treatment.
We follow the laws governing patient confidentiality and carefully guard the medical, insurance and financial information that we discuss with the patient, the family and/or guarantor.
The Menninger Clinic
2801 Gessner Drive
Houston, TX 77080
800-351-9058, ext. 5140
Fax: 713-275-5107
Online request for information
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   Menninger is a leading psychiatric hospital dedicated to
treating individuals with mood, personality, anxiety and
addictive disorders, teaching mental health professionals
and advancing mental healthcare through research.
The Menninger Clinic | 800-351-9058 | 713-275-5000 | Houston, Texas
Affiliated with Baylor College of Medicine and
The Methodist Hospital in the Texas Medical Center
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