Medical Necessity & You
Medical Necessity is typically the most critical factor considered when seeking authorization from insurance companies for eating disorder treatment. Insurance companies look for evidence that the eating disorder is having medical consequences on the physical body; examples of this include low body weight, low heart rate, low blood pressure, and abnormal blood work. However, as you likely have observed in your child, eating disorders affect much more than just the physical body—they affect behavior, thinking, and emotion. Consequently, when insurance companies deny continued authorization of treatment, citing that a client “does not meet medical necessity,” parents and the treatment team may agree that more treatment is crucial for sustained recovery.

We, at Center for Discovery, do our absolute best to work with the insurance companies to ensure that our clients get an adequate length of treatment. Virtually all insurance plans evaluate continued treatment using their own guidelines for medical necessity. When a client is ready to transition to a lower level of care, we will help you find the right treatment option for your child. Unfortunately, it is not uncommon for clients to be denied authorization before they are ready and have met the vital therapeutic milestones detailed on the Recovery Report Card™. We know that once clients have shifted into making real progress, the benefits of another week or two of treatment can be invaluable. With this in mind, we will do everything we can to support you in securing an appropriate length of treatment for your child. If you are denied authorization, your therapist will discuss several options with you. These options may include working with the insurer to flex treatment benefits or using personal resources to cover continued treatment. Please know that when a family chooses to use personal resources, we discount our usual private pay rates to match the insurance rates and direct families to financing options that can make treatment accessible and affordable. We are committed to working with you to ensure that your child receives the best possible outcome from their treatment experience with us.

Support in Recovery™
It is our privilege to provide you with Support in Recovery™, an invaluable resource on your path to recovery. Discovery offers three distinct support programs; Eating Disorders, Mental Health and Substance Abuse. These unique programs are FREE to all and consist of separate parent and adolescent groups that meet simultaneously at locations throughout California, Washington and our newest addition coming to Connecticut. One does not need to have gone through a Discovery residential program to attend the meetings. Support in Recovery™ meetings are for our community and open to those seeking recovery, support or information.

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