Living With Food: The Science Supporting Eating Disorder Treatment

Understandably, insurance and payment for care is of great concern to anyone contemplating treatment for their eating disorder. Historically, eating disorders have not been well understood or treated with parity by payers, and people with eating disorders or their families have been asked to bear the vast amount of cost for the treatment for these disorders. While insurance coverage for eating disorders is in the process of improving, in many cases it is no where near as good as we would like it to be. 

Prior to admission into a program at CCED, a detailed conversation with our director of billing will take place to determine coverage for our services.  In general there are two separate pathways that will happen at this point: 

1. If your insurance company is contracted with CCED, we will work with you so you can access benefits that have been guaranteed through those contracts. In general this means that clinical information from the person who did your assessment is shared with your insurance company.  For some insurance companies with whom we have contracts, no prior approval is needed for coverage, however, this is not true for all companies that we are contracted with. We will not know until after your assessment and subsequent conversation with our billing department into which category your situation may place you.  If we are contracted with your insurance company, in general you may be responsible for a deductible and coinsurance for your services and the insurance company will reimburse us directly for a percentage of the cost of your care.  
2. If we are not contacted with your insurance company, we will attempt to negotiate what is known as a single case agreement. Many companies, particularly those who do not have other resources in Northeast Ohio (and there are no other resources similar to CCED in Northeast Ohio) are willing to treat us as if we are in network even though we are not and they will negotiate a rate with us for payment.  With several of these companies we are in the process of joining their network and have a good relationship with them. With a single case agreement in place, you are likely to be responsible for a deductible and coinsurance, but the insurance company will reimburse CCED directly for services. 

As must be clear by now, the insurance piece of obtaining treatment is very complicated. We will do our best to give you as much information in the earliest possible moment, but we often need to take several steps through the process before we can be certain how your insurance company will interact with your treatment needs.

Should you have any questions or comments regarding this post, please contact blog@eatingdisorderscleveland.org

Contributions by Sarah Emerman