When you seek professional help for substance use (or any other behavior), you made a deliberate decision to eliminate outside distractions and focus on self-improvement. The last thing you should have to do is reconsider your choice because of confidentiality concerns. However, that's easier said than done, because if you enter a rehab or treatment facility that accepts insurance, your stay won't stay confidential or private for very long.
The unfortunate truth of addiction treatment is that anonymity is promised but impossible to maintain. Any program that accepts insurance or is a 12 Step program that includes a medical diagnosis and medical treatment is a program that exposes its patients' records to people they'll never meet. From psychiatric counseling sessions to methadone doses, every detail of your treatment is documented for payment purposes.
So who, exactly, will have access to your rehab records? Before you seriously consider any rehab or other drug and alcohol treatment providers, learn why the following people may be involved in your deeply personal journey.
Every time your doctor, therapist, or counselor meets with you, they take notes about your progress and their own prognosis. Whether they or a staff member turn these notes into medical records, you can be sure that a transcriptionist will eventually enter them into the computer, translating treatment techniques into medical billing codes and making sure the right medical, clinical and legal language is used in your claims.
After your insurance company receives these records, someone will be assigned to your case to determine whether your medical need was legitimate. This is problematic enough on its own, because you could receive unexpected bills that throw off your budget if you don't answer intrusive questions or provide even more details. However, even if everything is processed smoothly, there are multiple people at the insurance company who must be involved in the entire process. Some reviewers may be at on site at your drug or alcohol rehab to review and others may review after the records are received at the insurance company. Often the records are reviewed multiple times when there are denials, resubmissions and further reviews are requested which can bring further levels of review and — you guessed it — more people into the process.
Because rehab records are medical and clinical records, many patients assume their permission is required to reveal them to a third party. However, court orders may at times completely circumvent this policy. If your rehab stay is one of the conditions you must meet to move past a drug possession or drunk driving charge, your judge may request legal proof. You could even find yourself in court years later for something that isn't criminal at all, such as a custody battle, and watch helplessly as a judge subpoenas your records to verify your financial or medical status or the determination of your fitness as a parent.
At Saint Jude Retreats, we are a nonprofit program with a fixed cost stay based on your choice of accommodations and only accept private payments. Because we're not a medical or clinical facility and we don't interact with insurance providers for payment, there won't be any records of your stay with us. In fact, even the workbook you maintain during your self-directed journey will be for your eyes only. If you want to destroy your personal paperwork before leaving, you may feel free to do so if that celebrates helps you to clear your slate for your future. You can also choose to keep your text and workbook as a reminder of how far you have progressed in your journey — it's all up to you as you control the record of your stay.