Partnering with Insurance Providers Makes Recovery Possible
By Colleen Kula
Director of Admissions
 Since the welcoming of our first resident in 2006, Timberline Knolls
Residential Treatment Center has proactively campaigned to help make
treatment available for women who need it, including minimizing financial
hurdles by maximizing insurance coverage. From Timberline Knolls' medical
director, Dr. Kim Dennis, testifying before the Illinois legislature to
urge passage of the state's parity law to Timberline Knolls securing
contractual partnership with more than ___ different providers, four years
later, we've definitely made progress.
No matter the course, the mission at Timberline Knolls remains to make a
real life difference for our residents. From the moment we begin the
admissions process, our team remains in constant contact with referral
sources, parents and other family members to help find the best possible
treatment path for patients and residents. Yet this dynamic course doesn't
stop at admissions; it continues until the resident realizes the recovery
she desires and deserves. Like our clinical team, the admissions staff
becomes energized when patients want to recover, and we are relentless
about researching the benefits and the care that are needed for her
success.
 To that end, Timberline Knolls recently announced a relationship with
Blue Cross Blue Shield with whom TK is now in-network, enabling us to more
easily provide treatment support for so many more patients. Additionally,
the country's largest independent behavioral health care company,
ValueOptions, just selected Timberline Knolls as a provider in its
Diagnostic Specialty Unit (DSU) Program, in which TK has been specifically
recognized to treat eating disorders, dual diagnosis, complex adolescent
cases and complex cases that might benefit from intensive Dialectical
Behavioral Therapy (DBT). Timberline Knolls also has established in-network
contracts with many other important providers including Aetna Behavioral
Health, Cigna, LifeSynch/Humana, Private Healthcare Systems (PHCS),
ComPsych, and Interplan Health Group.
At Timberline Knolls, the admissions department is there to serve and
tirelessly supports each and every family by helping them navigate their
policies to know and understand what their mental health benefits are,
finding ways to reduce costs and conducting complementary benefits checks
to determine the specific out-of-pocket costs. We work with insurance
carriers to realize the maximum benefits for women, and because most
benefit companies recognize Timberline Knolls' success at helping women
make real-life changes and avoid repeated relapses and hospitalizations,
we're able to partner with providers so residents receive treatment on an
in-network basis. Families profit from lower out-of-pocket expenses, and we
not only coordinate the reimbursement process at the beginning of a
resident's stay, but manage to ensure coverage from intake to discharge. As
a result, residents and loved ones see our admissions staff as their
advocate ready to serve throughout the whole recovery process. Even when an
out-of-network situation arises, the admissions staff puts together their
collective experience and taps into their strong relationships with a
variety of providers in this category to direct families on how to minimize
overall costs. Additionally, there are instances in which Timberline Knolls
recommends the reciprocal referral program, offering the continuum of care
that secures the most appropriate treatment for families as well as the
clients our referral sources serve.
It's noteworthy to understand that while federal legislation currently
requires insurance plans to provide coverage for mental illnesses, eating
disorders and addiction disorders equal to what they provide for physical
illnesses, still today, roughly 67 percent of adults and 80 percent of children
requiring mental health services do not receive the help they need in large
part because of discriminatory insurance practices. At Timberline Knolls
Residential Treatment Center, we understand that the cost of care for women
needing treatment for eating disorders, substance abuse and other affective
disorders is a barrier for recovery. We know the financial burden often
disrupts lives and causes emotional turmoil—and yet we believe that
only treatment will make possible and fulfill long lives for the women who
need it.
So what's on the horizon for health insurance and eating disorders? An
industry advocacy group has been hard at work attempting to make treatment
of eating disorders a public health priority. The group's goal is to build
further momentum around the proposed FREED Act (Federal Response to
Eliminate Eating Disorders Act, H.R. 1193). This is the first eating
disorders legislation to comprehensively promote research, treatment,
education, and prevention programs. The good news is that with early
detection and adequate and appropriate treatment, eating disorders can be
overcome. As with other mental illnesses, we know that eating disorders
need not be hopeless, chronic, or deadly and that early diagnosis and
treatment bring greater chances for survival and complete recovery. That's
why Timberline Knolls will continue to support initiatives like the FREED
Act that make care achievable for those who need it most. |
