The year is winding down, and now is an ideal time to use insurance benefits before they expire. For many people, however, insurance can be a confusing and overwhelming topic.
There are several common questions referring providers have related to insurance coverage for eating disorder care. In this reference guide, we’ll answer some of these questions, define common insurance-related terms, and provide a brief overview of some insurance companies we work with at The Emily Program.
“Will my insurance cover eating disorder care?” is a question we get quite often. The best person to find answers to this question, however, is the client. It is the client’s responsibility to contact their insurance provider to determine what portion of care will be covered by their specific plan and what portion will be their part to cover. Insurance plans are an agreement between an insurance company and the person insured, so these two parties are the ones equipped to have that conversation.
We have an insurance verification tool on our website that can help guide the client’s conversation with their insurance providers. These phone calls may be anxiety-provoking for some, so having an already compiled list of questions may ease some stress. The tool outlines the questions the client can ask their insurance provider, including some about out-of-pocket expenses and the number of sessions, if any, which may be fully or partly covered by insurance. “What is my deductible?” and “Is there a limit on the number of therapy sessions per year?” are just two of the many questions on the list.
Various insurance providers cover different areas of health. Some cover behavioral health or mental health (eating disorder treatment, for example), while others focus more on physical health (such as doctor’s visits or hospital stays). The client must contact their insurance provider to know if certain services are covered. If the client is still having issues about getting the information they need, we suggest that they call the insurance company’s “Health Advocate” or “Case Manager,” whose phone number is usually listed on the back of their insurance card.
We have a list of insurance providers with whom we have contracts on our website. The list is subject to change by the insurance companies, but a few companies we currently work with are as follows:
*In-network coverage in King County
If The Emily Program is not “in-network” under an insurance policy, the client may be able to utilize out-of-network benefits. Eating disorder treatment may take a while and this could lead to authorization challenges. Fortunately, we have working relationships with most insurers, and can often work with them on a course of action.
With complicated insurance jargon, navigating a contract, or having a conversation with someone from the insurance company, can be difficult. We have a guide on our website that defines terms commonly used when it comes to insurance. A few are below:
Questions are common when it comes to insurance coverage for eating disorder treatment. Below are some of the most-asked insurance-related questions that we receive:
Clients may have additional comments or questions. In this case, the client should call their insurance company’s Customer Service line, which can be found on the back of their insurance card.
More information can be found on our insurance page. Please call The Emily Program Client Accounts Team with questions regarding the services you have received, clarification on your statement, and payment plan options: 1-888-364-5977, ext. 1357.
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