Eating disorder treatment centers rate it

The insurer interpreted ZaleskiвЂ™s compliance with the treatment plan as a sign that she wasnвЂ™t sick enough to need 24-hour residential care. She received that message on a second residential stay following a relapse when the insurer cut off her coverage a couple of days into her stay. ItвЂ™s a dangerous message for eating disorder patients, according to Zaleski. When insurers deny coverage for 24-hour residential services or retract it through an ongoing utilization review process, the message to patients is clear: youвЂ™re not sick enough for treatment. вЂњ$5,000 may as well be $100,000 if you donвЂ™t have the means to cover it and you donвЂ™t have a safety net.вЂќ Get Sicker вЂњFor some people who need treatment, their deductible and coinsurance are unrealistic expenses,вЂќ saidВ Eddington. ERC also goes to the mat with insurance for patients and offers financial assistance for underinsured patients in need.Д®ven with insurance coverage, out-of-pocket costs can be prohibitive. Some families pay out-of-pocket while they appeal the insurance denial, but many cannot afford to do that.Д®ddington said ERC works hard to avoid surprise insurance denials, working with families to develop contingency plans-such as partial hospitalization-if insurance denies the admission. вЂњFor a lot of these women, it takes so much energy for the whole family to get them to the point where theyвЂ™re willing to accept help.вЂќ That leaves patients and families in a bad spot, according to attorney Lisa Kantor, a long-time advocate for insurance coverage of eating disorder treatment. If the facility determines that the patient needs 24-hour care, the insurer may still deny the admission. for adults and many patients must travel out of state to get care. But there are fewer than 1,500 residential bedsВ across the U.S.

Insurers wonвЂ™t authorize residential treatment until the patient arrives at the facility for in-person evaluation.

вЂњToday, we almost never see it,вЂќ she saidДespite improvements, insurance barriers remain. When ERC was founded in 2008, Eddington said nearly every patient faced health insurance exclusions for residential treatment or for eating disorders as a covered diagnosis. These regulations have improved insurance coverage, according toВ Cyndi Eddington,В vice president of Revenue Cycle Management at Eating Recovery Center (ERC). The STRIPED report suggests the average residential facility stay is 31 days and costs more than $1,200 per day.Дue to mental health parity lawsВ and other consumer protections, coverage for eating disorder treatment facilities must be on par with skilled nursing facilities. Subacute residential treatment like ZaleskiвЂ™s typically lasts longer.

Eating disorder treatment centers rate it