Wilderness Therapy Is Making Insurance Headway

Posted by Rick Heizer, MS, Owner, Executive Director of Evoke Therapy Programs on October 12, 2017

Rick 2017bLast week I received another call from a law office looking for background information about Evoke’s wilderness therapy program. She let me know her client, a previous parent of our program, was bringing a suit against their family’s insurance company. As I got off the phone I noted this case would make 7 current cases I’m aware of just this year, and 3 more already settled in favor of the families. Wilderness therapy is making significant headway in getting families insurance coverage.

Insurance policies are ever-changing with regard to facility authorizations, mental health/substance abuse coverage, etc., but there are laws that ensure insurance coverage for families regarding mental health treatment. The Mental Health Parity Addiction Equity Act requires insurance plans that include mental health treatments to provide those treatments equal to the medical benefits covered, and the Affordable Care Act requires greater mental health coverage to more insurance plans.

To further support insurance coverage for wilderness programs the organization Evoke Therapy Programs belongs to, the Outdoor Behavioral Healthcare Council, was able to have the National Uniform Billing Committee assign wilderness therapy its own revenue code. Now when families are pursuing insurance reimbursement, they can use this code, Outdoor/Wilderness Behavioral Healthcare, Revenue Code: 1006, with their insurance company.

There are lawsuits pending against several insurance companies refusing to cover outdoor/wilderness behavioral healthcare, but not all. I found out today that at least two companies have already input the new Outdoor/Wilderness Behavioral Healthcare Revenue Code into their systems, United Behavioral Health and California BlueCross & BlueShield. This is great news for the field of wilderness therapy, and will continue to assist our families to receive more and more insurance reimbursement from their insurance companies.

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