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Prosperity Haven has been renamed to Wellbrook Recovery, continuing with the same exceptional staff and program.
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How HPS Works For Drug And Alcohol Rehab In Wisconsin

Drug & Alcohol Rehab Covered By HPS

If you or your employer uses HPS, it’s normal to feel confused about what that actually means. Is it insurance? What does it cover? And how does it affect your benefits for treatment? Here’s a straightforward breakdown of what HPS is, how it works, and what it means if you’re looking for drug or alcohol rehab. 

What is HPS?

HPS (Health Payment Systems) is not an insurance company. HPS is a Wisconsin-based TPA (third party administrator) that manages health plans for employers or brokers.  

A Third-Party Administrator (TPA) is a company that manages and processes health benefits and claims on behalf of a plan sponsor (most often an employer, but sometimes an association, union, or individual plan arrangement), without being the insurance company itself. 

What’s confusing is that each TPA functions completely differently; some only process claims using a carrier network, while others—like HPS—also operate their own administrator network. So when you hear the term TPA, you might think of one thing, but in practice, TPAs can take on many forms.  

Why HPS is different than most TPAs

What makes HPS unique as a TPA is that unlike most TPAs, HPS operates its own administrator network. They have their own relationships with healthcare providers and are in network with many facilities and doctors.  

That means that even if an insurance company is out of network with a specific healthcare provider, it can be in network with HPS, greatly expanding healthcare access.  

For instance, Wellbrook Recovery is in network with HPS. So even if you don’t see your insurance listed on our insurance page, if your company uses HPS you can still get in-network benefits, even if your primary insurance is out-of-network with us. 

How HPS actually works

  • You have a standard insurance plan, with HPS administering it.  
  • When you access healthcare services, instead of billing the insurance plan, your provider bills HPS.  
  • HPS pays your bill to the insurance company 
  • You get the bill from HPS. 
  • You pay HPS  

Think of it like a manager you hire to be the go between you, your doctor, and the insurance company. They take care of all the annoying insurance company stuff, and you and your healthcare provider just get a clear, monthly statement that gets processed through HPS. 

What about Paymedix?

Paymedix is a completely separate aspect of HPS that handles payment. It is a payment platform that provides payment plans and handles payment for HPS clients.  

Healthcare providers that are in network with HPS do not necessarily use Paymedix to handle billing.  

At Wellbrook Recovery, we use our own billing office to handle payment. We provide flexible payment plans and interest-free financing, just not through the Paymedix platform. 

How can I verify my HPS benefits?

With Wellbrook Recovery, insurance eligibility verification is quick and confidential. Give us a call, and our experienced insurance specialists will clarify to you exactly what benefits you have available and what out of pocket costs you may have. Benefits will depend on a combination of your insurance plan, and your HPS plan.  

Will HPS cover my stay at an inpatient drug rehab?

Remember, HPS is not an insurance company. Whether they cover your stay at a rehab facility will depend on your insurance plan.  

What levels of care will HPS cover for drug rehabilitation?

Again, because HPS isn’t an insurance plan, coverage will depend on your insurance plan, not on your HPS plan.  What HPS will add is that even if your insurance provider is out of network with a healthcare provider, HPS can be in network with them, expanding your in-network healthcare options. 

What out of pocket costs will I have with HPS?

Out of pocket costs will depend on a combination of your insurance and HPS plan.  At Wellbrook Recovery, we never charge anything beyond what your plan outlines for required copays or out-of-pocket expenses. All costs are clearly explained during pre-admission, and we offer generous, interest-free payment plans to support affordability. 

In the rare case that your insurance company doesn’t follow through with expected payment, we will never charge you more than we initially quoted. We stand by our word and have a long-standing policy of honoring all pre-admission agreements. 

FAQs

What is HPS? 

HPS is not an insurance company. It’s a company that helps run your health plan by handling claims, billing, and insurance paperwork for your employer or group. 

How does HPS work with my insurance? 

You still have a regular insurance plan. HPS sits in the middle and manages how claims are processed and paid, instead of the insurance company handling everything directly. 

Does HPS decide what treatments are covered? 

No. Your insurance plan decides what is covered. HPS just applies those rules and processes the paperwork. 

Why does HPS sometimes show providers as in network? 

HPS has its own network of providers. So even if your insurance company says a provider is out of network, HPS may still be in network with them, which can open up more treatment options. 

How do I know what my HPS plan actually covers? 

HPS plans are different for each employer or group. The only way to know exactly what’s covered and what you’ll owe is to have your benefits verified. 

Is Wellbrook Recovery in network with HPS? 

Yes. Wellbrook Recovery is in network with HPS, which means many HPS plans can process treatment here at in-network benefit levels, even if your insurance company is otherwise out of network. 

Does Wellbrook Recovery offer payment plans if I have HPS? 

Yes. If there are out-of-pocket costs, we offer flexible, interest-free payment plans and explain all costs clearly before admission. 

 

 

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