Eating Disorders - Steps Towards Treatment
Pursuing Treatment Options and Insurance Payments
Aug 7, 2009
If presenting symptoms are pointing to the existence of a possible eating disorder, it is time to see one's personal care physician, and/or a trained, licensed professional. Eating disorders can be fatal, therefore, it is imperative not to take the symptoms lightly, but to follow through with obtaining assistance for treatment.
Purpose of an Evaluation
There are several reasons to obtain a comprehensive assessment, to include:
- Pinpointing what the problem(s) really is as opposed to what the problem(s) is not;
- Evaluating what level of medical care/intervention is needed;
- Evaluating what impact the condition(s) has had upon the patient;
- What treatment should look like, what method of treatment to pursue; and,
- If medical intervention is needed immediately.
Because eating disorders can impact multiple body systems, often, the services of several health care providers are needed to include:
- Physicians;
- Counselors;
- Therapists; and,
- Nutritionists.
Identifying Treatment Options
There are several types of treatment options depending upon the results of the evaluation, these include:
- Inpatient (where the patient take a short residential stay for several days or a couple of weeks, depending upon the program);
- Outpatient (where the patient meets with a trained professional while living at home or some other living accommodation);
- Residential (where the patient takes up residence for a longer period of time, usually for one or more months); and,
- Intensive Outpatient (where the patient lives at home but spends several hours several days a week at a treatment facility).
Treatment methods may change depending upon the needs of the patient, thus, time spent in treatment is also subject to change.
Eating Disorder Not Otherwise Specified Has Peculiar Problems
Because EDNOS has peculiarities, this can be a difficult diagnosis to obtain insurance coverage from. This diagnosis often contains symptoms from anorexia and bulimia and can be as fatal as the other two.
Mental Health Insurance Coverage
There are cases litigated due to the fact that some insurance companies do not recognize eating disorder diagnoses. Though eating disorders are listed within the mental health category, some states recognize some level of disordered eating, other states within the U.S. do not, as far as insurance coverage is concerned.
Because eating disorders often are time consumptive for the treatment curve, if payment is provided by an insurance company, it is often not enough for the amount of time necessary for treatment. Such was the case for Jannell Smith whose insurance provider (Magellan) refused to make additional payments for inpatient treatment. Smith was discharged home, and committed suicide a short time later.
Some others caught in a similar predicament included:
Dawn and Bart Beye who are suing their insurance company, Horizon Blue Cross Blue Shield, New Jersey, for refusing to pay for treatment after three weeks. The Beyes have $200,000 dollars in medical bills.
Jeff and Cindy Meiskin who are suing Aetna for refusing to continue payment for the treatment of their daughter. Their cost, $120,000.
Finally, it is important to determine from the insurance company:
- What will be and what will not be covered;
- If there is any coverage at all; and,
- For how long the insurance company will be willing to cover the cost of treatment.
This is a daunting task. Just reaching a point where treatment is acceptable to the disordered eating sufferer, to have to fight for payment for treatment is an unnecessary, cruel stumbling block. Again, eating disorders are known to be fatal!
It is important not to give up, especially if treatment is severely needed. It is important to fight. Fighting may mean communicating with one's state insurance commission or communicating with one's state and federal representatives. Secure the advocacy of treatment providers, if possible, as well.
Source
NationalEatingDisordersAssociation.org
 |
