Embarking on the journey to sobriety may seem daunting, akin to scaling a mountain. Join us for a conversation with James Evans, a key figure in Restore Detox Centers' admissions process. With nearly eight years of personal sobriety, James sheds light on the recovery path, discussing insurance complexities and the sensitivity required in taking initial steps towards transformation. In this episode, we explore parallels between significant life decisions and seeking treatment, offering heartfelt advice and practical steps for those ready to seek help. James, representing the hope and dedication against addiction, stands as a beacon for individuals facing life's crossroads.
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This is the Addiction Recovery Podcast with Steven T Ginsburg, founder of Restore Detox Centers in sunny California. Enjoy your experience. Hey there, welcome back to another episode of Addiction Recovery. I'm Steve Coughran. I'm here with Steven Ginsburg, as always, and today we have a special guest. His name is James Evans. He is the admissions director at Restore. James is so great to have you on the show.James Evans:
Thanks, Steve. Thanks for the little intro, Steven. Glad to be here with you too.Steven Ginsburg:
James, we are thrilled you are with us. The admissions process is such an imperative part of this journey and I'm so grateful that you represent Restore so well and you many times are the first and the only point of contact is someone as they are heading towards a solution.Steve Coughran:
And Steven I mean you've hired some great people at Restore. I love the team at Restore. I mean it feels seriously like one big family. Let me just kick things off by asking you this like what did you see in James when you hired him as your admissions director and what do you value most when it comes to James and just his overall approach to admissions?Steven Ginsburg:
A great question. There's two facets to the answer. First and foremost, James was a team member with Boots on the Ground at Restore. He was facilitating numerous recovery groups at Restore and I just saw the way he was connecting with people and his amount of empathy for the community. And James himself has a beautiful and miraculous recovery story which is his to tell. But he's absolutely part of that trudge and we started just slowly and surely branching him out to the recovery community as far as admissions goes and I very quickly saw that was his highest and best use and we transitioned in full time to that position and the rest is history.Steve Coughran:
That's great, and I can see that too. I can see that empathy. You know, every time I talk to James number one, he's super responsive. Number two just so easy and so comfortable to talk with, and I love that. So, james, let me switch gears over to you. Somebody's been listening to the podcast and they realize okay, I need to get help. Either I need to get help or I need to get this loved one help. What's the process to admissions at a place like restore?James Evans:
Yeah, so the process starts with calling in. You know, the line rings directly to me, I pick up the phone. Really, the first thing I like to do is just kind of assess the situation as far as, like, the level of crisis. Like where is this, this member, at? Are they, you know, are they safe? Or where they're at right now? Are they going to be okay while we kind of go through the admissions process? Is this a 911 situation where we have to move extremely quickly? Or is this someone who's calling for more information and they're planning on maybe coming in on Friday and it's Wednesday and we have some breathing room? Once I assess, really you know what the situation is, then we hop into the insurance verification process because really you know, our hands are going to be tied to what somebody's insurance will allow them to do. Right, Are they going to even be a fit for restorers and insurance we're able to accept? If it's not a fit for restore, then you know, do I have to get this person into contact with another facility, somebody that we work with, and stuff like that? So really it just begins with calling and touching base with us and then from there I just immediately go into problem solving mode and start moving as quickly as we can.Steve Coughran:
And it seems like, in addition to all the other barriers, like the stigma, like the social stigma behind, you know, substance abuse and addiction or denial or fear of consequences, or just lack of awareness, all these things it seems like the biggest obstacle is the financial side. That's just me speaking. I don't know if you agree with that, but what are your thoughts on that comment?James Evans:
So it can be. You know, it definitely is a large hurdle. We're fighting a fight and we are kind of really we're allotted to help the people who are able to be in our little corner of this fight. You know, and addiction is something that, from the lowest of lows to the highest of highs, it's going to either affect somebody directly, that somebody knows, or it's going to actually affect them, the individual. You know, people get sober in a Mercedes Benz and people get sober in a cardboard box and everything in between. And luckily, you know, I have created a really good amount of resources for most of that range. If there is the financial barrier between somebody coming in to restore, like I have resources to help people get help elsewhere. And then, if the insurance is the barrier, because some people are going to have HMOs, they're going to have EPOs, they're going to have PPOs, some people aren't even going to know what any of that means, they're just going to know that they have it right. And so it takes somebody like me who understands that and can go hey, you have a HealthNet HMO, I know this facility over here that's closest to you, they can do it. Or this facility doesn't have beds available right now because I called and talked to the rep, but this one over here does. You know, I've really kind of created myself as like a community resource and to be able to just help connect those dots for people.Steve Coughran:
No, I love that and you know what I really appreciate about what Steven has set up with. You know, the whole culture and just the whole vibe with restore is just the customer experience. And I mean, obviously you exemplify this, James, in your work. But, Steven, the question for you is, during the whole establishment of restore, you know, it seems like you've focused a lot on, like, the client experience from the first moment where they call restore, they make contact with restore, all the way to when they're leaving restore successfully with their program completed. You really invest in all these touchpoints. So so, when it comes to the admissions process, Steven, what kind of approach have you taken and what works? Well, because it seems like some facilities you know you call up if your insurance doesn't meet the criteria. It's like, okay, click, hang up, have a nice day. How have you approached things differently to help people on a more like holistic or a more grand level?Steven Ginsburg:
I think in this respect, I've got to pay proper homage to James here, and James and I have always enjoyed monumental alignment, which I'm very appreciative of. James is that guy if we can't help an individual, he is going to make sure we leave no stone unturned and getting the individual the help they need, and that in and of itself, which is a great reflection of James's journey, is indicative of our. This is our philosophy and our focus and our culture at restore. We are here to save lives. James is a humongous piece of that foundation to save lives, and everyone is on that same path. Everything we do, a day at a time, an individual at a time, a facet of time at restore is about saving people's lives.Steve Coughran:
I absolutely love that. And so, turning it back over to James, it seems like a big hurdle, you know as mentioning the financial side when it comes to insurance and understanding, okay, does my insurance cover this or not? I mean, that just seems so complicated. How do you help people, you know, work through that process so they could get the help that they need in a time, efficient and just, you know, just ease of process manner.James Evans:
So what I do is I'll have somebody submit their insurance information to me and then I'll submit that to our billers and what they do is they submit for a verification of benefits which gives us an explanation of what's covered, what's not covered, if there's going to be out of pocket costs. You know what does the insurance companies say that you are responsible for, what percentages are their co-pays and all that stuff right, which can sound like a lot If it's not really explained, because it really is a lot. It took me a long time to really like learn the ins and outs of all this but luckily, like I have our billers who explain it to me and then I just translate that to the person I look, you know can say look like, if you do come to us, this is what it's going to look like for one week, two weeks, a full 30 days. You know, sometimes people have in-network deductibles and out of pocket. Sometimes you'll have out of network stuff and I'll be able to translate what that'll look like at another facility too, if you know. If I have to refer somebody to another facility, so I do my best to really explain it as best as I can to someone so they can understand what they're looking at. And then two, I know a lot of times people just, you know, get told what they get told and don't really get to learn the you know the why and the how behind. You know what these numbers mean or anything like that. So I really try and take my time to explain that to someone because if I'm not the last person that somebody talks to because they have to go and talk to some other facilities, I want them to at least be armed with the facts moving forward to where they're not going to get misled or get something explained to them wrong.Steve Coughran:
So let's talk about it from the parent's perspective. So let's say a parent has a kid. The kid needs to go to rehab. They're still underage. How does a parent know whether or not their insurance like covers these types of situations, or does it Like does it cover minors that are on the parent's plan?James Evans:
So I believe and I you know I could be wrong I believe the cutoff is 26 or 27. I'm pretty sure it's 26 for the cutoff when somebody can no longer be covered by their parents insurance Because we we treat adults. I really know just that. 18 to 26, I believe it is. But so what I do is I get given the insurance information and just get it ran. You know, that's something that we'll have to see, based on the subscriber's information and the dependent's information, if they're, if they're, covered.Steve Coughran:
So is there something that people should be asking their insurance companies when they're signing up for insurance? I don't know. I just signed up for a health insurance plan and I'm like game, I like that deductible, I like this network and I'm good to go. I would never think to ask. Or my kids covered for addiction or recovery.James Evans:
Yeah, so to my knowledge, you would, you know, list the child as a dependent, and then you would have to ask the specific questions about the mental health and substance abuse benefits to get those answers directly from the insurance company.Steve Coughran:
That makes sense. Okay, switching gears over to Steven. How does your store involve and support families during the admissions process and throughout the whole treatment journey?Steven Ginsburg:
A great question and it's another. It's another element where James and I will work communally with the community many, many times, as the approach is occurring and there's loved ones helping loved ones, there'll often be times and I'm I'm very pleased and proud and I expect James at this point to continue to do this, which he does. He'll literally tell him hey, I understand the trepidation, I understand your concerns. Above and beyond, james is doing so much hands on for work, steve is getting things prepared, he's clarifying this maze of insurance many times till tall the families. The owner of the company, who's in recovery himself, actually wants to jump on with you guys, kind of give you some, some elements and understanding of what the programming is like, what to expect, and he will segue myself in with the family, with the person directly or the loved ones, and that is really awesome because it takes a lot of the confusion, the weight off of it and James can continue to focus on the objective, which is how a person and as quickly as possible. So many times people are in acute or subacute detox time to waste. But it's about fast tracking answers, giving people reassurance and them understanding it's all hands on deck.Steve Coughran:
Well, I love that and I love that about James is he's definitely a problem solver and, like we've been talking about, if he can't find the answer right, then like he'll go to work, find the answer, find a solution, and that's really what I love about Restore is that the true mission is it's all about saving lives, right, and you guys do everything you can in your power to make that happen 100%. So let me ask you this, James, last question here I remember when I was in my early 20s I bought my first house, and I was young, you know, and I had my own business and I just I wanted to buy a house, but it seemed like the process is so complicated, especially being self employed. You guys sound like I had this W2 to show, I had, like my financial statements and everything was just like, you know, all over the place, and so I just thought, you know what I'm not going to get, get a house this year, I'll just keep renting because this is so complicated. I don't even know if I qualify. It seems like such a burdensome process and I put it off. And I put it off and then my brother is like, hey, you know, it's actually pretty easy, just do this and this and this, just connect with this person and go from there and, sure enough, it's like I submitted a few documents and then next thing, you know, I was closing on this house and I bought my first house. So I think, upfront, it seems like some processes can be really complicated and that could be a true obstacle for some people. So maybe you could provide just a little bit of reassurance of how easy it is to get help, because if I'm sitting at my home and I'm like you know, rock bottom, I'm just like in the darkest place ever and I'm like I need help. It just seems like, ah, it's so much work to get help, so I'll just stay in my miserable place. Maybe you could speak to that, james.James Evans:
Yeah, you know, and it's kind of funny because I've been on I'm now on both sides of that spectrum, going through the process Of you know me now being seven and a half, almost eight years sober. I'm going through the process of buying my first home, you know, and going through the and learning that a lot of this is easier than I kind of thought it was right Once I got in contact with the right person who explained everything. So I'm going through that right now in my life too, and I also, I was that guy for a long time where, you know, I'd go to bed and I, you know, I'd call on God, you know, when I needed some help or I needed to get out of this bind, and I'd make all the promises that I was going to get sober and work on it, and then I'd wake up the next day and I'd realize that I didn't have the means to really do it by myself, or I feel I felt like I didn't have the means to do it by myself and I would just keep on the way. I was going for a long time until I really hit that point where I you know, I luckily for me I reached out to my family for help and then my sister. You know she's the one who really put in the footwork, googling places, calling places and and talking to people. So I've been there before, right, and I think that that's what really allows me to excel in my position is I know what it's like to be there and I know what it's like to not know and to want help but not know what's there. And so for me, I would like just like to say to people is, you know, I can't say that everywhere, everywhere that you call is going to be a great program, but a majority of the places you call are going to be good or great programs and there's going to be someone who's like me or similar to me on the other side of that phone who is going to go above and beyond. You know I do a lot of great things. I tried, you know I like to think that I'm super special, but I really, you know my position and what I've created was very monkey, see, monkey, do I met other really good people in the recovery community and I just emulate what I saw them doing, which is going above and beyond to try and help people and try and save lives. So you know, even if your first call isn't to us, there's going to be someone who's going to be willing to help you. I can't say that it's going to be everywhere that you call, but there's a good amount of other people who are really doing the right thing in this fight. So it just takes taking that first step, that little bit of willingness, just barely cracking open the door and in reaching out and asking for help and whether it's a call to restore or it's a call to somewhere else is getting in contact with somebody who's in the field and that can. Just that little bit of willingness that opens the door could just open the floodgates and get you in contact with, with who you need to to get you that help.Steve Coughran:
No, and that's great, and I totally lied because I said that's the last question, but you just. But you just prompted another thought. If somebody is calling for help and they're just calling around, are there things like one, two or three things that they should definitely ask or definitely do their homework on before looking to be admitted to a certain facility.James Evans:
Definitely, yeah. So one thing that is very personal to me, just because of my wife's story with her getting sober definitely, if you have insurance and you know you have insurance ask what does my insurance cover. Make sure that you know, hey, I want to submit my insurance and see what my insurance covers. So that way you don't just get quoted some price for the stay and you know, you never know you could have had insurance and you never know if a place does or doesn't take insurance. Definitely, if you have it, try to utilize it first. Definitely, call around and check with a few places. But what's super important, I would say, is A making sure that if you have insurance, you try to utilize that first for coverage. B you know if you have the ability or see if they're even willing. Like a lot of times you get in contact with someone and they're just like hey, I'm ready to go to treatment and they, you know we move quickly and we bring them in because they're in crisis. But if you have a little, if you're, if you're blessed enough to where you know, you have a little bit of leeway before you come in, like if a place is willing to give you a tour of the facility before you come in. I think that that speaks volumes. You know, there are going to be some places that just have a really nice website and are going to want to bait and switch you and get you in there as quickly as possible. And I think if a place is willing to open their doors to you, whether you come to them or not, and we'll take the time to show you the facility, and hey, you can work. You know we're always going to be here if you need help. If you need help today, 30 days from now, six months from now, like we're not going anywhere, right, and we don't. You know we don't need to drag you in the door by promising you things that are unrealistic right. So we'll open our doors for you, we'll show you the facility, we'll let you meet staff and if it's comfortable and you think it's going to work for you, come on in. We're here to help, you know. But if you, you know, if you ask some place, like hey, can I tour your facility and check it out first, and they're like well, no, I don't really want you to see the place. I mean that's kind of a could be a red flag, you know. So I definitely think that there's a. You know that's something important that if you have the time to ask, definitely do that and then just make sure that the feeling's right who you're talking with, and just just make sure that it feels right for you. You know, when I went through the process and I called through you know some, and it did. There's nothing wrong with larger, bigger facilities, but I've just I've talked on the other side of the of the line to places when I was seeking help and it just for me it just felt too like clinical and you know, for for me, being an alcoholic or like a young partier when I was getting sober, it just felt too much like I was talking to a doctor's office, right. And then when I finally got on the phone with somebody who was like me on the phone, it just felt right. I knew I was talking amongst my own people. So I went with like that gut feeling when I decided to go to the facility up here in Marietta and Temecula where I live. You know, when I got in contact with them I knew it was the right place, because I just talked to a guy on the phone there and I went with that gut instinct and you know the rest is history. I've been sober for almost, you know, seven and a half, eight years now, so I think that those are probably the three most important factors.Steve Coughran:
Okay, that's great, very helpful. James, thank you so much for being on the show and sharing your expertise in this area. I think you provided some really good insights for the listeners. I'll just say a few things and I'm going to turn it over to Steven to wrap up the episode, but if you're listening and you want help, you could always reach out to us at RestoreDetoxCenters. com. Go to our website. You'll get all our contact information Also on the website. We have great tools like a couple of eBooks out there that will guide you through the process, and if you have any comments or questions or you just want to say hello, you can email us at hello at RestoreDetoxCenters. com. And then, finally, I'll just say this you know, because some people are starting to take interest in this side of the business, if you want to get involved, if you want to look for ways to donate and get involved with our foundation, you can also send us an email hello at RestoreDetoxCenters. com to learn more about how you can support this grander mission that we're on. Steven.Steven Ginsburg:
Steve. Thank you so much. James, just kudos, Well done, just a perfect job, representing who you are, what you do and the hope that you provide just within your story and within Restore. And I just want to let families know out there. You may have some questions for James. You may want to talk to James, you may want to pick James's brain. Just contact us at the Hello Restore Detox Centers and you will hear from James yourself. And that doesn't mean that you're committing to come in and restore. We don't care about that. What we care about is that we make contact and that we can get to James's point, get that doorway opened, get some dialogue going and either be part of the solution or help you find your way to the solution or someday be your solution. But everyone's life is at stake. That's why this is so imperative and important, James. That's why your role is so imperative, important and, steve, as usual, thank. Thank you from all of us for helping us continue to focus on the truth and the solution. Everybody have a safe and sober day.