burning tree lodge

By: Philip Hensarling, Director of Utilization Review

Burning Tree Lodge


Burning Tree Lodge is a 90-day substance abuse treatment center located in Elgin, Texas. Treatment at Burning Tree Lodge includes a 12-step approach, dual diagnosis, medication management, psychotherapy, and comprehensive discharge planning. Our facility accepts private insurance to supplement the cost of treatment. Burning Tree Lodge is also JCAHO accredited and is licensed by the state of Texas for residential substance abuse treatment.

Since December 2017, I took on the role of Director of Utilization Review at Burning Tree Lodge after serving as an Admissions Specialist. As an alumnus of Burning Tree, I’ve developed a passion for helping families and their loved ones in the recovery process.

As Director of Utilization Review and with the help of the Burning Tree leadership team, we have been able to make significant progress in improving the quality of care. By moving from outsourced utilization review to in-house utilization review, Burning Tree Lodge has increased authorized days for a residential level of care by 25% from 2017 to 2018.

Review Process

The utilization review (UR) process begins with a UR representative making a pre-certification call within 24 hours of admission, once the verification of benefits (VOB) has been reviewed. The insurance company is provided with patient and administrative information such as client name, DOB, ID number, facility name, tax ID and address. Clinical information is then relayed from three assessments: pre-clinical, intake and nursing. Insurance companies will review from either the national criteria, American Society of Addiction Medicine (ASAM)[i], or state criteria, Texas Administrative Code (TAC)[ii]. Insurance companies can also go a step further and establish their own medical necessity criteria, such as 24/7 on-site nursing. After the pre-certification call, the insurance company will authorize or deny an initial number of authorized days, which are offered in portions of approximately 4-14 days. Per TAC standards, the average length of stay for 24-hour residential treatment is between 14-35 days. Length of stay is determined by applicable criteria or standards met for continued stay3. The responsibility of the UR representative is to convey, with the help of clinicians and doctors, how the information presented in the client’s chart meets the appropriate criteria or standards. Clinical reviews are typically requested on the last authorized day of each portion of authorized days. A licensed therapist or nurse from the insurance company evaluates the information presented then provides a decision to authorize, step down to a lower level of care or discharge a client. If authorized, the insurance company will issue an authorization number which enables the facility to bill appropriately. If denied, a peer review will be scheduled with a medical doctor. An appeal may be requested thereafter by an independent 3rd party if authorization still isn’t granted.

Common Practice

Substance abuse treatment facilities often have UR representatives either working off-site or out of sight, which potentially allows for a higher caseload. This may even make a great deal of sense as far as the bottom line is concerned. On the flip side, contact with co-workers by phone or email only can limit their ability to communicate and problem solve effectively. When working in a high-stress environment, delays in communicating critical information can lead to team members feeling helpless awaiting a response. Negligence is more likely to occur in a bottleneck of communication within an organization. Pressure also creates a potential to manufacture dishonesty which leads to more mistakes. Finally, something is bound to slip through the cracks, i.e. lack of medical follow-ups, missed appointments, missing pertinent past diagnoses and/or medical history, incorrect or incomplete treatment plans and/or therapeutic interventions, missed collateral contacts, issues with discharge planning, etc. This ultimately impacts the quality of care.

Innovative Practice

In order to manage the flow of information between operations, clinical and medical, it is essential to establish a role dedicated to utilization review within the leadership team that operates on-site. Direct contact mitigates problems, insulates clients from negligence and creates an environment for meaningful relationships to culminate, which everyone can agree is the foundation of both good business practice and long-term sobriety.

  1. Democratic Approach: Burning Tree maintains a democratic approach to the treatment of substance abuse clients in residential treatment. Collectively, our professional clinical staff weigh in and vote on therapeutic interventions, treatment plans and individualized discharge plans. A democratic approach addresses two main problems that are often a pitfall in counseling: counter-transference (the emotional reaction of the counselor to the client’s contribution) and lack of communication. This approach provides oversight and limits the risk of errors due to work overload by maintaining a level of accountability in a system of checks and balances called “Master Treatment Planning,” which is a weekly meeting attended by clinical, operations and medical staff. By working directly with operations, adjustments to scheduling can be arranged to coincide with scheduled reviews for UR. Questions asked by care managers can be answered by operations, clinical or medical in minutes rather than hours. If your life were at stake wouldn’t you rather have a team of professionals making decisions on your life rather than just one professional?


  1. Increased Accountability and Protection Against Negligence: Paired with a treatment team the utilization review department is an asset rather than an adversary to clinical, medical and operations. My experience of most UR relationships is one department is always “doing it wrong” and playing the blame game. When UR specialists are either off-site or tucked away in a separate building, they do not have direct communication which influences the quality of care. Establishing the UR department in an on-site leadership role creates a layer of accountability that protects counselors from “dropping the ball” which inevitably trickles down to the client. After all, it’s easy to overlook emails and miss phone calls from the UR department regarding specific information. Medical appointments and follow-ups must be scheduled timely. Clinical problems must be identified, and treatment plans or therapeutic interventions followed up on. Direct flow of communication creates a symbiotic relationship between medical, clinical and operations. It would be illogical to assume that having the one department that relies on operations, clinical and medical not be on-site to coordinate the flow of vital information which must be relayed accurately to insurance providers. The right hand must talk to the left in order to be effective in any treatment-based platform. An on-site UR department is the glue. An on-site Director of UR has direct contact with medical and clinical daily which allows problems to be identified quickly, solutions implemented and progress to be measured then relayed to providers. An added benefit is having answers to the care manager’s questions before they’re asked.


  • Non-Clinical Relationship: The UR representative’s role within the organization should also include a non-clinical relationship with every client. Burning Tree offers a daily “Community Group” which focuses on accountability through a 12-step lens. Pertinent information can be charted then presented to the treatment team by the UR representative. From the insurance company’s perspective, a chart on a screen suddenly becomes more like a real human being suffering from a chronic disease, with the help of an established non-clinical relationship. For example, if you’re in the market for a used car, would you rather buy a car from someone who knows the car inside and out or buy sight unseen from someone states away?

An on-site Director of UR, with proper processes and procedures implemented, helps create a client focused continuum from admission to discharge. A client-focused approach is the way out of the dark shadow unethical treatment centers have created for the industry. My personal belief is authorizations and dollars will flow provided we act with integrity in our business of serving others first. When non-clinical, clinical, operations and medical work together the client wins.


[i] ASAM Criteria


[ii] Texas Administrative Code – Admission Criteria for 24-hour Residential.


[iii] Texas Administrative Code – Continued Stay Criteria for 24-hour Residential


90 day treatment programs

If you or someone you know needs professional addiction treatment but is delaying help due to fears or preconceived notions about the process, it’s time to lay anxiety to rest. People who have been through alcohol and drug addiction treatment programs have only positive things to say about their experiences. Many even credit treatment programs with saving their lives. The time to fight for a better life is now. Don’t let the following fears or misconceptions delay your recovery. Professional help can enable you to achieve lifelong sobriety.

Treatment Is too Expensive

One of the main deterrents standing between many addicts and recovery is fear of the price of treatment. No price is too high, however, to get your life back. An addiction treatment program could be your door to sober living, mental well-being, and the power to resist relapse. It could be your ticket to new job opportunities, repaired relationships with loved ones, and physical health. Don’t let the price tag on a program stand in your way if it’s the right one for you. Staff members at Burning Tree Lodge help clients with costs through insurance benefits whenever possible.

Everyone Will Judge Me

Fear of what others will think can be enough to stop some people from seeking professional help. Instead, they attempt to get sober “quietly,” on their own. There is a reason treatment centers exist. Self-recovery has a very low success rate. Even if you manage detox and stay sober on your own, your odds of relapse are higher if you don’t have the strong support system and foundation you receive during professional treatment. In many cases, trying to self-detox can be fatal. Seeking treatment won’t sully your reputation with people who truly care about you. In fact, it often earns loved ones’ respect.

I’ll Lose My Job or Custody of My Kids

Joining an addiction treatment program means explaining to your boss, your friends, and your family members where you’ll be for the next 30 to 90 days or longer. Making this commitment can be a tough and scary decision. If you don’t seek help, however, you could lose your job and your family anyway. The Family and Medical Leave Act gives you permission to leave your job for medical reasons for up to 12 weeks without fear of job termination. You have a much higher chance of retaining child custody by seeking addiction treatment than you do continuing substance abuse.

It Won’t Work

Finally, a common fear is that a rehab program simply won’t work. If you’re afraid of spending a great deal of time and money on an inpatient program, only to relapse the day of your discharge, talk to a professional. Speaking with an expert on the subject can help you realize that you’ll have a team of people dedicated to your long-term recovery. During a long-term rehab program, you’ll learn important tools you can take with you long after you leave. The right program will have support systems and therapies that stick with you for life. Call (877) 874-8695 for more information about our 90 day drug and alcohol recovery program today.

length of stay improves success rate

When first researching addiction treatment and recovery centers, pay attention to how long the program lasts. Sometime in the 1970s, the typical length of stay for an addiction treatment program became 30 days. The origins trace back to the U.S. military, which permitted active-duty soldiers to seek treatment without getting reassigned if they returned to duty within 30 days. However, times have changed. Studies have shown a correlation between longer treatment programs and higher recovery success rates.

What’s Wrong With the 30-Day Setup?

A traditional 30-day program might not be right for you. Although this short-term setup might be enough to detoxify the body and introduce someone to treatment techniques, it’s not enough to effectively treat an individual or give him/her the tools to achieve long-term recovery. Instead, it acts like a Band-Aid, patching up the problem without getting to the source of the injury. Someone struggling with a serious addiction requires more time and professional assistance to get to the other side.

Although a 30-day program is better than nothing, research tells us the average person needs at least three months (or 90 days) of addiction treatment to stop drug or alcohol use. It takes about three months for the brain to “revert” to the way it used to think prior to the drug or alcohol dependency – or for the individual to reach a point where he or she can truly stop substance abuse. Discharge after just 30 days means the individual is still battling desires and compulsions to use and has high odds of relapse.

Relapse can occur regardless of the length of stay in addiction treatment. Relapse isn’t a failure, but a sign that the person needs to adjust his or her treatment strategy. It’s up to the individual to do things that will minimize the risk of relapse, such as signing up for at least a 90-day treatment program instead of a short-term one. Longer treatment times can achieve better outcomes by consistently measuring progress and tailoring a long-term plan for permanent recovery. Ongoing support from professionals for at least three months can make all the difference.

Where to Find a 90-Day Rehabilitation Program

If you know a 30-day program just isn’t right for you or a loved one, research options for longer treatment plans. Burning Tree Lodge has helped chronic relapsers since 1999. The facility’s 90-day course of treatment deepens its commitment to helping others obtain permanent sobriety. The Lodge 90-Day Program includes services such as psychiatric evaluations, mental health counseling, individualized treatment planning, relapse prevention, daily therapeutic activities, and more for people with all types of substance abuse disorders and dual diagnoses.

The Lodge firmly believes in the superiority of the 90-day program to short-term 30-day ones when it comes to achieving permanent recovery. It also understands that economic shortcomings could get in the way of someone’s ability to sign up for a 90-day program. The staff at the Lodge always strive to maximize insurance reimbursement and benefits to ease the cost of long-term treatment plans. It is their mission to provide effective treatment to everyone who needs addiction recovery. Learn more during a confidential discussion.



tips for supporting a family member or loved one in recovery

Recovery is an individual journey, but not one a person must trek alone. The support of family members and loved ones can make all the difference in a recovering individual’s motivation to remain sober. If you have a loved one who recently joined a treatment or rehabilitation program, there are things you can do to facilitate long-term recovery. While you must let your loved one forge his or her own path, you can offer support from the sidelines with a few proven tips. Try these seven techniques to support your loved one during addiction recovery.

Voice Your Support

Don’t assume your loved one knows he or she has your support. Recovery is a difficult journey that involves a lot of self-reflection, analysis of past mistakes, and asking forgiveness from people the addiction hurt. Your loved one might not know that you’re willing or able to help or may be too embarrassed or afraid to ask. Make your views known by voicing your support and desire to help during recovery. Make the first move. Say: “I’m here to help in any way I can,” and see what comes next.

Assist With Independence

Learn the difference between support and enablement. Enabling refers to a loved one encouraging a drug or alcohol dependency, usually unintentionally, through acts such as giving the recovering individual money, food, or shelter. Show your loved one you care about his or her recovery but encourage independence. For example, help your loved one get a job instead of just giving him or her money. Visit a support group for friends and family members of addicts for tips on how to avoid enabling.

Plan for the Future

Give your loved one something to look forward to by helping him or her create a plan. This plan can include finding a job, getting housing, taking up hobbies, and building or repairing relationships. Your loved one’s treatment or rehab center should have given him or her ideas and tips for an aftercare plan. If they didn’t, however, create the plan yourself with help from a counselor.

Promote a Healthy Lifestyle

Encourage the sober individual’s physical and mental well-being if possible. Cook healthy meals, encourage exercise, stress the importance of good sleep, schedule doctor appointments, and help with social interactions as much as possible (without becoming codependent or telling the individual what to do). The line between guiding and ordering can be a difficult one to walk but do your best to support without commandeering the person’s recovery journey. All choices must be the individual’s own, but you can promote healthy choices with gentle pushes in the right direction.

Attend Al-Anon Meetings

Meetings with professionals aren’t just for the person struggling with addiction. Al-Anon is an organization that hosts meetings around the world for people just like you – friends and family members of people with addictions. Becoming a member can give you the support and tools you need to better facilitate long-term recovery for your loved one. Al-Anon meetings can help you feel less alone with your own personal struggles and feelings. It can also lend proven tips for helping someone close to you achieve long-term remission.

Get Help

If you believe your loved one is on the verge of relapse, get help. Urge your loved one to return to treatment or at least speak to a counselor. If this isn’t your loved one’s first relapse, consider a program that specializes in helping chronic relapsers, such as Burning Tree Lodge. Our 90-day treatment program helps people with multiple relapses obtain permanent remission. Contact us today for a confidential discussion.


help loved one stay sober

Your loved one has committed to a life of sobriety. He or she has completed rehab and you’re ready to celebrate. You may think the hard part is over, but your role as a friend or family member has only just begun. Now it’s time to show your support in this lifelong journey by helping your loved one through each 24 hours. There are things you can do to make sober living easier for your loved one. Start with these four strategies for helping someone stay sober after treatment.

Avoid Pitfalls

Learn your loved one’s struggles and help him or her avoid bad situations, especially immediately after leaving rehab. Rehabilitation facilities are safe spaces that facilitate healing and sobriety. Out in the real world, it can be more difficult to avoid situations, people, places, or emotions that bring back the need for drugs and/or alcohol. Do your best to support and encourage the individual in the right direction, away from pitfalls that may interrupt recovery.

Create Goals and Plans

One of the mental barriers people often encounter while adjusting to sober living is the fear of missing out. After treatment, people who are new to sobriety might feel bored or restless in some situations – especially at times where the individual would previously have used drugs or alcohol. Create healthy, positive goals and plans with your loved one to give him/her something to work toward. Create a plan for healthy eating, regular exercise, and fun, productive hobbies. Setting goals for the future can make it easier for your loved one to manage temptations.

Prevent Codependency

Codependency in this case refers to an excessive reliance on a partner who requires support due to alcoholism or drug addiction. Codependency often comes with enabling. Although you should demonstrate your love and support after addiction treatment, consciously try to avoid becoming codependent. Signs you could be codependent include:

  •       Providing money for things other than treatment
  •       Only finding satisfaction in life by satisfying your partner
  •       Remaining in the relationship despite harm your partner causes
  •       Feeling anxious when you can’t fulfill your partner’s wishes
  •       Making excuses for bad behaviors

Being in a codependent relationship with someone who struggles with addiction can interfere with both of your emotional needs. Don’t make excuses for addictive behaviors. If your loved one relapses, provide support by telling him or her to return to treatment, not by offering money or food. You aren’t responsible for ensuring your loved one doesn’t relapse. Seek help from a therapist for more tips on breaking a habit of codependency and/or enabling.

Stay Positive About Recovery

One of the most important things you can do to facilitate long-term recovery is to stay positive. Remember, there is no “cure” for addiction. It is a lifelong process. A positive, healthy home filled with people who love and care about the individual can facilitate good physical, mental, and emotional health – and help eliminate the need to use. If you wish to help your loved one stay sober for life, a 90-day program can be a strong foundation. Learn more at (877) 874-8695.






importance of aftercare in successful recovery

Recovery doesn’t have an end date. It is a lifelong process that sober individuals learn to take one day at a time. Some days will test a recovering person’s resolve to stay sober more than others. An accredited inpatient treatment program is a wonderful first step, but true lifelong sobriety depends on what the individual does after. Learn about the vital role of aftercare in recovery, and how to make it part of you or your loved one’s long-term addiction treatment plan even after the 90-day Program.

What Is Aftercare?

There might not be a cure for addiction, but there are proven ways to live a fulfilled, sober life. An integral part of the plan is aftercare. Aftercare refers to a personalized plan an individual has for when he or she completes primary treatment and rehabilitation. No two aftercare plans are the same, but they have many things in common. A successful aftercare plan provides support during ongoing recovery through proven practices and habits to help a sober individual stay motivated moving forward on the sobriety journey.

The best treatment centers help create tailored aftercare plans, rather than simply releasing individuals to fend for themselves after rehab. People who are fighting to beat alcoholism or drug addiction can benefit from professionals overseeing at least parts of their aftercare plans. Professional assistance from a high-quality treatment program can help prevent relapses and facilitate long-term success. A high level of support shouldn’t end after initial treatment but continue for life. Aftercare is key.

What Does Aftercare Look Like?

As a friend or family member, you can help aid lifelong recovery by understanding the importance of good aftercare. Each person’s recovery looks different. Your loved one’s aftercare plan should be 100 percent unique; tailored for his or her exact needs, triggers, and goals for the future. If you need help creating an aftercare plan, don’t hesitate to ask a treatment center for assistance. Three main elements of a standard aftercare plan are:

1. Stable relationships. Aftercare isn’t complete without contributions from stable, positive, supportive (and often sober) friends and family members. Stable relationships can guide a recovering person through remission and help prevent relapses. Aftercare should include an attempt to repair broken relationships and create a loving and supportive home.

2. Self-responsibility. Although it’s important for a sober individual to have the support of his/her friends and family, the person undergoing recovery must learn lessons in self-responsibility. One must hold oneself to a high standard of living and aim to become a productive member of society.

3. Financial independence. A fine line exists between supporting and enabling. A common form of enabling is giving a sober person money, food, a home, etc. After treatment, one must achieve financial stability to successfully reenter into society. An aftercare plan should include a suitable job or career for the individual.

4. Participation in AA and the 12-Steps.

These are just three basic pillars in the average aftercare plan. The specifics will vary widely from person to person. One of the most important things to keep in mind is to stay positive in all the things you do as the loved one of someone leaving addiction treatment. Staying positive about sobriety and the future during aftercare can remind your loved one why staying sober is worth the effort. Your attitude can go a long way in supporting their success.



show dont tell

Alumni: Megan Souther

Someone with a drug and/or alcohol problem has one goal, to continue to get high or drunk at any cost. Addicts will say things they don’t mean and manipulate any situation to get their desired result. Anyone who stands in the way of them getting their next fix or drink is considered an obstacle. People closest to them are the ones who get hurt the most. How do I know this? Because I am one.

In my addiction and early recovery, I would tell friends and family what they wanted to hear, if it would get them off my back.  I would go to different treatment centers and tell the counselors and my family that I was doing well. I was compliant, which came off as surrendered to the process and getting sober. That was far from the truth. At one of my rehabs, I even had the name “4.0 Rehab Student”. I worked the steps and tried to be an example to other clients. I said a lot while really saying nothing about what was really going on inside. The truth was that nothing was fine. I would get out of treatment and immediately relapse. While everyone was surprised, I was not. I knew I had been faking it and I had everyone intention of getting loaded the day I left treatment. The reason this happens is that addicts are very skilled at manipulating and being dishonest.

At Burning Tree, we understand the nature of the disease, which is why we don’t focus on what they are saying. Their behaviors speak loud enough. Addicts are skilled at saying a lot, without really saying anything. An example of this would be someone telling us they want to be sober, but are breaking rules, not doing treatment work, and not being honest about what is going on inside them.  Their actions are telling us they are not willing to do something different to be sober.  Not only the staff, but other clients at Burning Tree hold their peers accountable for their behaviors daily. At Burning Tree, we hold up a “mirror”. This is how you are showing up and this is what you are saying. From there, we can help the client see what is really going on and begin to rely on a Higher Power rather than their sick mind.