nsurance companies are sooooo frustrating to deal with - you are not alone!
Due to individual insurance regulations and federal rules there is no "set" coverage that all insurance companies have to go by. Your best bet when seeking coverage is to call your insurance company and get a Case Manager to walk you through the to-dos.
The earlier you contact your insurance company in the process, the better. Additionally, the more "evidence" for need of treatment (doctor's referral notes, lots of documentation) that you have the better.
I made a round-up of the previous 3 blog posts (updated the links so they are current)
that I wrote about on insurance and packaged it up in a PDF for you.
Get it here:
How to get your insurance company to pay for treatment
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Unfortunately, unless it is part of a treatment program, Dietitians are very rarely covered by insurance. (Wha?!)
You can petition your insurance for some reimbursement by asking your RD ("nutritionists" without the RD credential are never covered because they are not qualified) to send you a "superbill" for services that have been provided (typically annually or quarterly) to submit to insurance (after paying out of pocket) to try for reimbursement. With enough supporting documentation (again, referrals from medical doctors help a lot!!) you can often get reimbursement (no promises, each company has it's own ways of dealing with each individual).
Good luck!! I hope this helps!
If you have more tips on how to get insurance to pay please leave them in the comments below, or email me to have it included.
(originally posted 4/18/2016. libbysfitnutrition.com)
Eating Disorders are expensive to treat! Acting early can save time, health, and money, but many insurance companies do not deem it "medically necessary." See my other insurance posts for more info.
Here is a list of resources to gain knowledge from in the fight towards individual and nation-wide coverage (some of these are repeats from my previous posts).
(originally posted 2/16/2016. libbysfitnutrition.com)
Treatment of eating disorders is costly - no two ways about it. Residential treatment can cost $100's to over $1000/day! And a lot of insurance companies are denying coverage for treatment. Here are some tips I found to help with getting insurance coverage, or the cost of treatment if not through insurance:
"If your insurer balks at your requests for coverage, ask to be assigned a case manager...A case manager can often (though not always) help you get access to additional care. Insurers normally do not cover nutritional counseling, for example, but a case manager authorized six visits to a [dietitian] for one of Dr. Herrin’s patients.
If the case manager cannot help you, you will have to take a route familiar to almost anyone who has tangled with an insurer. Get in touch with your employer’s human resources department, and ask them to go to bat on your behalf. If your employer and your insurer will not budge, make a formal appeal to your insurer. If your appeal is denied or not answered, contact your state’s insurance commissioner or even your representative in Congress.
Extreme though that may sound, it has been known to work. Susan M. was able to get her daughter’s lengthy residential treatment covered by enlisting the help of her senator’s office. An aide called the Department of Labor, and after several more steps, the insurer ultimately agreed to cover the treatment.
You might consider contacting a lawyer for advice on your rights and legal precedents in your state, as well." - New York Times (2010). Treating Eating Disorders and Paying for It, By Lesley Alderman.
Remind your insurance company that eating disorders are a medical illness. The most likely medical complications from an eating disorder are cardiovascular events (heart failure), growth failure, irreversible osteopenia, and sudden death. Suicide rates are also high among people with eating disorders. Nutrition counseling for prevention or treatment of an eating disorder is cost-effective for the insurance company.
Some specific insurance company nutrition policies:
CenCal Health (I am a provider):
Requires a Physician referral (RAF form), for any nutrition counseling, then covers 2 hours/month (as of Feb 2016).
Anthem Blue Cross: https://www.anthem.com/medicalpolicies/guidelines/gl_pw_c164431.htm
(originally posted 12/21/2014. libbysfitnutrition.com)
As a Registered Dietitian, I don't often get to work with insurance, due to the fact that nutrition services are rarely covered by any form of insurance. How frustrating!
(Personally, I will write up a "super-bill" for you to submit to your insurance in hopes of getting reimbursement for nutrition services. I also take CenCal Health Insurance.)
Certain insurances, or certain levels of "illness" may get you full or partial coverage for nutrition counseling/Medical Nutrition Therapy by a RD (not just any "nutritionist").
Anyway, I have found a few articles by other websites/authors that may help you in your quest to get covered for services related to an eating disorder... good luck!!
P.S.- if anyone has more tips on getting reimbursement, please post in comments or e-mail me!
Libby is a Registered Dietitian focusing on eating disorder treatment and prevention. She is working on the central coast to create wellness in individuals and the community.
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