Navigating insurance issues in eating disorders treatment is a complicated topic. Every treatment program has different contracts with different stipulations about what is covered and what isn’t. Even within a program like The Body Image Therapy Center, those contracts vary by location. Here are some key questions and answers that come up from clients at Body Image.
What insurances do you take?
We are in-network with Carefirst, which is part of the BCBS network and allows us to take all BCBS products at all four locations and for all levels of care. In addition, we are in-network with Aetna in our Maryland and DC offices for all services and levels of care, and we bill out of network in Alexandria. BCBS and Aetna cover the vast majority of individuals in the MD/DC/VA area, especially federal, state and local government employees. United Healthcare/Optum and Cigna allow us to bill in-network for our IOP and PHP programs, though our medical services and individual mental health services are out of network or fee for service at this time. We are an approved out of network provider for TriCare as well. We in the process of adding more insurance carriers all the time, and this list will continue to grow and become more comprehensive.
How do I know what my costs will be?
As part of the intake process, we collect your insurance information from you at the time of your initial inquiry to perform a benefit check on your behalf. This is done as a courtesy and does not guarantee payment. Every effort on our part is made to get insurance to cover as much of the cost of treatment as possible. We will inform you what your insurance shared with us, but it is always best practice for you to contact your insurance company and verify information. You are your own best advocate.
What happens if you don’t accept my insurance?
In rare cases when we are not in-network with your insurance and there are no out of network benefits, we can request what is called a Single Case Agreement. Your insurance plan may allow us to operate in-network on this one course of treatment. We are happy to explore this option when necessary.
Do you accept Medicare or Medicaid?
We do not accept those insurances but are happy to refer you to programs that do accept public health plans.
Do you offer a sliding scale for services not covered by insurance?
We do offer an option for clients to apply for financial assistance, but it is not guaranteed. Our policy is to address patient requests for what is termed “charity care” or “financial hardship” after their insurance has processed claims. We do not waive claims at The Body Image Therapy Center as that could lead to legal issues related to the False Claims Act, Anti-Kickback Statutes, and non-compliance with managed care agreements. To address the issue of financial hardship, we have created the following policy to assist clients who have financial concerns. Charity care is essentially free care when the client simply has little to no means to pay for needed medical services. Financial hardship is when a client has limited means and a sliding scale is considered. The benchmark we use for determining if a client is eligible for charity care or financial hardship is family income between 100% and 400% of the Federal Poverty Level (FPL), which is updated yearly by the U.S. Department of Health and Human Services. Proof of income and need is evaluated on a case by case basis and only when financing options like CareCredit are denied. For more information please contact our Operations Director at 877-674-2843 x 701.
The Body Image Therapy Center is located in Baltimore and Columbia, Maryland, and Washington, D.C. For more information please contact our intake department at 877-674-2843 x 0 or firstname.lastname@example.org.