Eating Disorder Treatment for Bay Harbor Islands Residents

Below is a simple script and checklist you can follow when speaking with ViaMar’s Admissions Team to confirm your insurance benefits for eating disorder treatment.

Sample Opening Script

Hi, I’m calling to verify my insurance coverage for eating disorder treatment. I want to fully understand my benefits before moving forward. Can you help me check these details?

Key Questions to Ask ViaMar Admissions

1. Network Status & Eligibility

• Is my plan in-network with ViaMar?

• If some services are out-of-network, which ones are still covered?

2. Levels of Care Covered

• Which levels of care does my plan cover?
  (Residential, PHP, IOP, outpatient therapy, nutrition counseling, and medical monitoring)

3. Prior Authorization

• Does my plan require prior authorization for residential or PHP?

• If yes, can ViaMar assist in obtaining authorization?

4. Covered Services

Ask whether your plan typically covers:

• Individual therapy

• Family therapy

• Nutrition sessions

• Medical monitoring or labs

• Psychiatric services

• Medications, if needed

5. Costs & Billing

• What out-of-pocket costs should I expect?
  (Deductibles, copays, coinsurance, out-of-pocket maximums)

6. Length of Treatment

• Are there limits on the number of days or sessions covered?

• How does my plan handle additional care if more treatment is needed?

7. Medicaid Plans (If Applicable)

• If I have Medicaid or a Medicaid-managed plan, is this specific plan accepted?

8. Appeals or Denials

• If my insurance denies or limits coverage, does ViaMar help with appeals?

9. Additional Fees

• Are there services or assessments that may not be covered and could create extra charges?

10. Required Paperwork

• What information or documents do you need from me to begin the insurance verification process?

Use this script and checklist when calling your insurance company to verify coverage and understand your financial responsibility for treatment at ViaMar Health.

Sample Script for Calling Your Insurance Company

Hi, I’m calling about my behavioral-health benefits, specifically for eating disorder treatment at ViaMar Health. I’d like to verify my coverage and financial responsibility.

Key Questions to Ask Your Insurance Provider

1. Network Status

• Is ViaMar Health in-network for my plan?

• If not, what out-of-network benefits do I have for eating disorder treatment?

2. Covered Levels of Care

Ask clearly whether your plan covers:

• Residential eating disorder treatment

• Partial Hospitalization Program (PHP)

• Intensive Outpatient Program (IOP)

• Outpatient therapy, nutrition counseling, and medical monitoring

3. Prior Authorization

• Which services require prior authorization?

• Who is responsible for requesting the authorization — the provider or me?

4. Costs

• What will I pay for in-network PHP or residential treatment (copay or coinsurance)?

• What is my deductible, and how much of it has been met?

• What is my out-of-pocket maximum?

5. Session or Duration Limits

• Is there a limit on the number of therapy or nutrition sessions?

• Is there a maximum number of covered residential treatment days per year?

6. Medical Necessity Criteria

• What criteria does my plan use to approve eating disorder treatment?

• How often are progress reviews required to maintain coverage?

7. Appeals

• If treatment coverage is reduced or denied, what is the appeal process?

The length of treatment varies depending on the individual’s needs, but most patients stay in residential care for several weeks, with follow-up care through PHP or IOP.

While residential treatment requires staying in our facility, patients transitioning to PHP or IOP can often return home or stay in nearby accommodations for more flexibility. We also offer a Virtual Treatment (Telehealth) program that provides comprehensive, high-quality eating disorder care to patients anywhere in Florida. Through secure video sessions, ViaMar’s team of therapists, psychiatrists, dietitians, and care coordinators deliver personalized therapy, meal support, and group sessions directly to your home. This remote option is ideal for those with mobility or transportation challenges, or anyone without nearby treatment facilities, offering care in a familiar environment that supports real-life healing and skill use.

Yes, we specialize in treating eating disorders alongside co-occurring conditions like anxiety, depression, and trauma.

We have dedicated programs for both adolescents and adults.

Contact us for a confidential consultation to discuss the best treatment options for you or your loved one.

Yes, family visits are encouraged as part of the recovery process. We have specific visiting hours and guidelines, which our staff will provide upon admission.

Aftercare support includes follow-up appointments, group therapy sessions, and access to our alumni network. We provide resources and support to help maintain recovery and manage any challenges post-treatment.

We offer a comprehensive relapse prevention program, including continued therapy and support groups. Our team remains available to re-assess and adjust treatment plans as needed.