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Eating Disorder Treatment & Insurance Issues in California

Kantor & Kantor, LLP Understands This Difficult Time

Dealing with, and seeking treatment for eating disorders can be emotionally and financially devastating. When your health insurance company gives you a hard time, or when it denies payment for benefits, matters only go from bad to worse.

Kantor & Kantor, LLP can help you to become familiar with mental health parity laws, be knowledgeable about what services are available to you through your insurance company, and become an advocate for your health.

For many clients, residential treatment is the most appropriate and effective level of care for treatment of their eating disorder and related conditions. Contact us today for more information!

The American Psychiatric Association’s Practice Guidelines include residential treatment as an essential step in the spectrum of treatment for eating disorders, falling between inpatient hospital care and outpatient care. Professionals involved in the treatment of eating disorders have produced concrete evidence that residential care treatment is optimal to prevent relapses and promote healing because it addresses both medical and psychological issues. Some insurers ignore this accepted standard of care, however, providing coverage only for hospitalization or outpatient care.

What can you do?

  • Familiarize yourself with your insurance policy or health benefit plan. Obtain a copy from your employer or insurance company if you don’t have one.
  • Understand the insurance policy’s coverage for treatment at an in-network facility versus an out-of-network facility.
  • Ask your insurance company for a list of in-network treatment facilities.
  • If the insurance company has no in-network facilities in your area or state, ask your insurance company for a single case agreement with your preferred treatment facility in your area.
  • Document that the treatment is medically necessary by providing your doctor’s written support, your own letter describing your need for treatment, and if available, letters of support from family members or co-workers.
  • Document what forms of therapy and treatment you have exhausted by submitting copies of all treatment records to the insurance company.
  • Ensure that your facility communicates with the insurance company in writing and retains records of correspondence.
  • Keep records of all out-of-pocket expenses for future reimbursement.
  • Find out if your state has a Mental Health Parity Law. The National Alliance on Mental Illness has a chart outlining the mental health parity laws for each state. ( www.nami.org).
  • Obtain a copy of the treatment facility’s license to determine if it qualifies as a hospital, skilled nursing facility, congregate living facility, or other health facility license through the state.

Seeking treatment for an eating disorder can be overwhelming, intimidating, daunting and confusing. It’s imperative that you become aware of the treatment that is available to you, and the necessary steps for receiving this treatment through your insurance company.

In order to obtain residential care, policyholders frequently must sue their health plan or insurer to pay for treatment. That’s where we come in. We are one of only a few law firms in the United States that will represent eating disorder patients denied health benefits for residential treatment.

Kantor & Kantor, LLP has developed a specialized legal practice representing clients whose claims for treatment of eating disorders, and dual diagnosis (substance abuse and other co-morbid conditions) have been unfairly denied by their health insurers or benefit plans. Kantor & Kantor, LLP’s aggressive approach to litigation and legislation has brought justice for clients who have found themselves fighting for their insurance benefits when benefits were wrongfully denied.

Contact Information:

Lisa S. Kantor
Kantor & Kantor, LLP
lkantor@kantorlaw.net
(877) 783-8686

Eating Disorder Resources

What Sets Us Apart?

  • Free Case Consultations Provided
  • 160+ Years' Collective Experience
  • Thousands Of Cases Successfully Handled
  • You Don't Pay Us Unless We Recover Your Claim
  • Selected For Inclusion In The List Of Super Lawyers®

Client Testimonials

  • there are no words that can express the feelings of gratitude and relief I have that you helped us

    “I wanted to thank you again for all of your help. My daughter would not be in treatment without your help. I can never thank you enough, there are no words that can express the feelings of gratitude and relief I have that you helped us, and I believe saved my little girl. Taking her back to Timberline Knolls was very difficult in many ways, I wish UBH could know the damage they have done to her by having her go in and out like this. When she went into Timberline Knolls the first time she was not happy to go exactly, no one wants to go into treatment, but she was open to going in and ready, for the first time, to really look at her issues and work hard to get better. When she had to leave Timberline she expressed that she wished she could have stayed because she felt like she was finally at a place where she was getting better and, though it was hard, she was really opening up and dealing with her issues for the first time, something she has had a hard time doing. I just wanted you to know that she was going down to a really bad place and without you I don't know what would have happened except that she would not be at Timberline Knolls right now getting better and I thought you should know this. With unending gratitude.”

    R.

  • Your compassion for me and my situation is very much appreciated.

    “My thanks to you for pursuing my case with vigor. I don't know much about how these legal things are handled, but I could tell by your communications with me, making sure I was always informed, that you were on top of it all. Also, you were ALWAYS available to me to answer questions, and your compassion for me and my situation is very much appreciated. I have had limited exposure to the legal system and attorneys, but I have never been able to just call and talk to them, as I could with you. I always had to speak with someone in the office that couldn't really answer my questions.”

    D.B.

  • First of all, I want to express my extreme gratitude for probably saving my daughter's life.

    “First of all, I want to express my extreme gratitude for probably saving my daughter's life. By staying in treatment, the improvement is remarkable. She had been in eating disorder facilities many times, and treatment had been interrupted repeatedly by Anthem Blue Cross's denying benefits. Many of the health professionals were telling me that maybe my daughter was a hopeless case. You both gave me hope. She is still struggling with some residual issues around eating, but the change in her attitude, her ability to assess her own recovery, and her wish to live instead of to die, is evident in her life. Now she is back in school, after years of having her education disrupted by the eating disorder. She goes places with friends, and even goes out to restaurants for fun! This year marked the first holiday season for many years, when she had not been in a treatment facility. Other people gave up and you didn't. I can't thank you enough. You took the action that was necessary to keep my daughter in treatment long enough for it to work.”

    Anonymous

  • I am so grateful for all your efforts and I'm sure glad you were on my side fighting for me.

    “Dear Alan - I just wanted to send you a special note of thanks for all your hard work on behalf of me and my case. I am so grateful for all your efforts and I'm sure glad you were on my side fighting for me.”

    Tracy R.

  • Thank God for Kantor & Kantor.

    “Thank God for Kantor & Kantor and Denise Anderson. I appreciate everything you do!”

    Stephen Schaffer