Eating disorder clinic again taking Wellmark patients
BACKGROUND
The Emily Program in
Intensive treatment is expensive, so TEP requires patients to pre-authorize coverage of their treatment with their insurer, and TEP had worked with
Eating disorder treatment coverage has always been difficult to obtain from insurers, but Lampert said TEP was seeing patients with pre-authorized coverage later be denied coverage after completing treatment at TEP.
However, some patients experienced denials a
Pfab pre-authorized for care, but later found out she was denied coverage and was on the hook for tens of thousands of dollars. Shen she contested the claim,
WHAT'S HAPPENED SINCE
Two of about four TEP patients' cases involving disputes with
"We're hopeful that this problem has been remedied by
She also said she knows the
TEP is accepting
"We say something like, 'it's important for you to be aware that we have had these problems with
Lampert said they're asking
l Call for pre-authorization and ask for a case manager right away
l Request a full copy of the insurance plan
l Have and document the conversation with the insurance provider about pre-authorization
"We underscore that conversation with
l Comments: (319) 368-8516; [email protected]
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