Nutrition Intervention for Eating Disorders: Coordination of Care


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attention, energy, and paperwork involved in obtaining reimbursement for health care. Obtaining insurance cover- age for eating disorder treatment is rarely straightforward and often requires many exchanges back and forth between insurance personnel, the insured, and treaters. There are many issues. There is no one evidence-based treatment method that


guarantees successful recovery from an eating disorder. Research is, at times, difficult to translate into clinical prac- tice and vice versa.3-6


Therefore insurers hesitate to cover


eating disorders treatment that is not proven effective.7 The view of eating disorders as behaviors of choice per- sists even though the biological basis has been confirmed.4 Mental health care coverage benefits are not always ade- quate for the long course of treatment that may be required. Insurers waver on whether nutrition therapy for a mental illness is “medically necessary,” even though the Ameri- can Psychiatric Association (APA) guidelines indicate that it is.2 If you work in a facility, it is likely that payment for


your services is rolled into a single per diem charge. You may never know if your services are being directly reim- bursed or paid for by insurance, and you may not need to know. If you work in your own practice, reimbursement is more complicated. Even if you are a provider contracted with an insurance plan, your patient’s reimbursement may still depend on his or her diagnosis. For example, you may be a provider for the patient’s insurance, but your services may be a covered benefit only if the patient’s diagnosis is diabetes. If you are not contracted with an insurance company,


then you are an “out-of-network provider.” Your patient may have different coverage for in-network and out-of- network providers. If there is no alternative provider in your area that your patient could meet with (or no other


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