Using LifeSynch for Bulimia Treatment
LifeSynch, which is dedicated solely to behavioral and mental health concerns, can be used to help you or someone you know overcome bulimia and begin the recovery process.
Does LifeSynch Cover Bulimia Nervosa Rehab Programs?
Yes, LifeSynch covers bulimia nervosa rehab programs in most cases. If you or someone you know suffers from bulimia nervosa, anorexia nervosa or an eating disorder not otherwise specified, treatment is probably covered by LifeSynch.
LifeSynch provides access to a participating behavioral health network of providers, coordinates treatment services and acts as a patient advocate. In determining the services and treatment programs to approve during its utilization management review, LifeSynch follows the written clinical review criteria found in The Mihalik Group’s Medical Necessity Manual for Behavioral Health.
Call us at for more information about bulimia nervosa rehab programs available to you or someone you know. We are available 24 hours a day to answer your questions and help you or someone you know find help for eating disorders.
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Inpatient Treatment Length LifeSynch Will Cover (28-30, 60, 90+ Day)
If the disorder is acute enough or the patient’s physical or mental condition has reached a level of severity that is imminently life-threatening, then hospitalization, partial hospitalization or placement in a residential facility might be warranted. The degree of the illness combined with psychosocial factors and the presence of additional diagnoses guide the treatment plan, which is developed in consultation with the patient, family or others who provide support and a multidisciplinary team of providers. Such a team typically includes a physician, a psychologist or therapist, a psychopharmacologist for medication needs and a nutritionist. As part of the treatment plan, the need for hospitalization or another level of care will be assessed.
If the patient is hospitalized, the provider must submit a request for authorization of treatment to LifeSynch for utilization management review. LifeSynch bases the decision to authorize treatment and its duration in large part on the details of the treatment plan, diagnosis, description of patient’s day-to-day functioning and recommended level of care. The appropriateness of care, medical necessity and existence of coverage determine whether LifeSynch authorizes additional days of treatment.
If you or someone you know would like assistance in locating inpatient bulimia treatment programs near you, call us anytime at . We also can help find outpatient treatment programs.
LifeSynch Coverage for Bulimia With Dual Diagnosis
People experiencing an eating disorder like bulimia often exhibit other mental health disorders called “co-occurring disorders.” When bulimia and other mental illnesses coexist in the patient, the patient is considered to have a dual diagnosis. According to the National Center on Addiction and Substance Abuse (CASA) at Columbia University, up to half of individuals with eating disorders, including bulimia, also abuse alcohol or drugs, compared to 9 percent of the population. Depression, anxiety disorder and other mood disorders frequently co-occur in people with bulimia. People with bulimia commonly also suffer from obsessive-compulsive disorder. For dual diagnosis patients, identification of and treatment for all health-related conditions are important in the recovery process. If you or someone you know is dually diagnosed, then seek out treatment options that are able to address all the concurrent conditions.
LifeSynch usually covers treatment for both bulimia and other mental illnesses. If you or someone you know have been dually diagnosed, then consult with your insurance plan representative and share your proposed treatment plan in advance to be sure to maximize the amount of benefits received. If you want help finding outpatient programs or residential facilities that specialize in dual diagnosis anorexia treatment, then please call us at .
Specialty Bulimia Treatment Treatments Using LifeSynch
If the patient and provider demonstrate the medical necessity of the treatment, then LifeSynch might approve the program or partial coverage. Approval of a specialty treatment program requires that the requested services be the most appropriate available and that they follow generally accepted medical standards. Treatments with clinical research and evidence that support their use typically are more likely to be covered than those without any supporting research and evidence.
Other specialty programs, such as luxury and executive treatment centers that offer additional amenities at greater expense, or treatment facilities exclusively for followers of a certain faith, will likely not be covered by LifeSynch or any other insurance company.
How to Cover What Insurance Doesn’t Pay For
Treatment of bulimia usually is sometimes more costly than treatment for either medical or psychological issues alone because effective treatment of eating disorders requires an integrated, multidisciplinary approach to care involving a team of specialists who provide comprehensive medical, mental health and nutritional services. Estimating the cost of treatment must factor multiple considerations into the calculation, including location, level of care, inpatient or outpatient setting, duration of treatment, follow-up care and presence of other conditions requiring treatment.
Medical benefits coverage might be detailed separately from mental and behavioral health services. Be sure benefits available through both insurance policies have been fully exhausted. Also, exhaust all available appeal options for any claims for coverage denied by the insurance company. Frequently, review by an insurance analyst at a different level in the company produces a different determination, and lower-level denials can be overturned in some cases.
In the United States, outpatient treatment typically costs about $500 to $2,000 a day. Treatment in a residential program costs approximately $30,000 per month on average, with most stays lasting at least three or four months. Most insurance companies are reluctant to authorize coverage for stays in facilities for more than 30 days. Most insurance plans require the patient pay for at least part of the costs, and the patient usually is responsible for paying this portion of the cost through copays.
Bulimia causes serious health consequences, including:
- Electrolyte imbalances that can cause heart failure
- Damage, including inflammation and rupture, to the esophagus from vomiting
- Tooth decay
- Peptic ulcers
Immediate eating disorder treatment is critical, regardless of cost. Even if insurance does not cover all costs, treatment for you or someone you know should not be delayed. All financial sources must be explored, including financing options available through the treatment center.
Verify Insurance Coverage and Find the Best Treatment Programs
Whenever possible, verify insurance coverage and authorization request requirements prior to beginning treatment in order to minimize the chances that claims will be denied. First, carefully read any insurance policy documents to become familiar with terminology, covered services and coverage limitations. Follow up conversations with insurance plan representatives, employee benefits staff, medical claims personnel and other relevant, knowledgeable persons to verify details or obtain further explanation. Document these conversations and any other discussions relating to coverage or the treatment plan. These notes serve at least two purposes: They can remind you of details otherwise not recalled, and they can aid in any appeals that might be necessary for denial of claims.
In addition to verifying what is and is not covered by insurance, verify the processes required by LifeSynch for obtaining authorizations for treatment. Following the prescribed process minimizes the likelihood that payments for services will be delayed or denied. To know more about the benefits of using LifeSynch for eating disorder treatment, call our 24/7 helpline today.
Armed with information about the coverage limits and potential out-of-pocket expenses, the patient or patient’s family is better prepared to search for the treatment program best suited to their particular combination of benefits coverage, ability to pay in the absence of insurance, and treatment options. When selecting a suitable bulimia treatment program, consider also proximity to family or other support, location in relation to transportation options, philosophy of treatment program and its providers, and ability to address dual diagnoses, if applicable.
For help finding the best bulimia treatment program for you or someone you know, please call us today at . We’re available to help you navigate through your options and help you understand the possible treatments available.