I'm not sure that I will frankly publish this. But I am going to utilize this time to vent my frustrations re: The Cost of Treatment/Insurance Carriers etc...
I have learned over the past 10 years at least that most insurance companies (who by the way absolutely control any one's treatment) operate very suspiciously. Notice that I did not reference ALL insurance companies b/c probably there is one out there that really cares about the treatment they offer their insureds - who knows. The games they play with client's health is almost criminal in nature. The manner in which they treat the provider is beyond criminal. But then the Mental Health Industry is often slighted regarding the treatment-end for the most part. As if the mind is not a organ of the body and therefore shouldn't ever have anything wrong with it!
And how insurance companies came to take over control? Well despite the fact that I am in the industry, abuse of the system that occurred starting way back in the eighties is where it began. Holy cow did people abuse the system in the eighties - often taking vacations in psychiatric centers to get away from work!
I personally think the cost of residential treatment for eating disorders is outrageous. I think there is certainly a need for residential care do not get me wrong. But I do feel often facilities take advantage of the individual and their family members as well. In some cases I know for a fact they often end up having the client totally dependent upon them and ultimately addicted to the recovery process within that facility. So the individual struggles to lead their own life perhaps in a different manner but still surrounding the eating disorder. They switch addictions so to speak and become obsessed with the treatment facility, other clients, and practitioners as well! This again does not occur in all situations but it does occur so buyer beware!
So watch out when you approach a treatment facility make sure you understand everything and use common sense with it. Here is where the problems begin though. Let's say residential treatment costs $30,000/month and that is a modest cost! Insurance Companies have to look out for their own bottom lines with situations like this. So often they will guard treatment days due to cost not due to how the client is. And frankly, the research states that it takes between 3-10 years to recover from an eating disorder. It is purely my thought that insurance thinks they'll never recover so don't blow the money! Those are what I think they say to themselves - I don't know that.
The fact of the matter is people with eating disorders can recover. And also can recover from the distorted eating patterns on an outpatient basis. But this doesn't pay the bills for the 'fancy residential facilities'. Outpatient is not where the $$$$ is. I would know this! And because of these facilities that charge excessive amounts of money insurance companies play the deny-delay games. A lot of Residential facilities don't take insurance (for good reason - insurance won't cover them)! So if you are in need of residential treatment be prepared to pay the cost in most cases! It is indeed a case of extreme excessiveness indeed.
Remember some really do need Residential. But residential is also used as a supposed 'quick fix' for the problem - and you are going to pay for that luxury - and do they really teach the individual to learn to live their lives without the ED? I don't know.
I do know that individuals don't fully recover in Residential and often they end up in our programs where we actually have the responsibility of teaching people how to live their lives and recover! So this is how I know people can recover without Residential! Life can be grand if someone is doing everything for you within the facility and all you have to do is show up. It all comes to a grinding stall when you are faced with living your life and recovering! Making healthy choices takes on a whole different light and that 'Pink Cloud' of residential fades away to reality!
Now back to the 'deny-deceive-delay' game the insurers play. OMG outpatient facilities like ours don't have all the fancy amenities the residential facilities boast of which is directly related to their high bottom line! But how the insurance companies handle their insureds at this level is indeed criminal. They do exactly what the game they play states: deny treatment, deceive the provider, delay delay delay payment. I probably can speak for most outpatient facilities we do the real recovery work with people suffering with eating disorders. Yet we are the ones the insurance companies mess with.
By now you might be saying to yourself - well don't take insurance make your program self-pay...Well that is tempting but part of my ethics include providing affordable treatment to assist clients and their families into recovery. So hence allow for insurance companies.
It is indeed a shame! And frankly I'm pretty sure it's cheaper for them to get sued by 1 individual rather than dole out treatment to many! These are just my thoughts! Yes I'm frustrated because I have spent my entire career attempting to help people and I see clearly the games that are played with their lives from many directions!
Well Thank You for allowing me to vent - this is truly a dilemma for someone who cares if people recover... But I'm doing something about this it's ridiculous to complain if you don't plan on changing something! You can check on the site if you are interested in the changes but I'm trying to get out of this sick game being played with those suffering from eating disorder sufferers!
Deb
If You have any thoughts about what I've written please feel free to comment.
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