Eating Disorder Treatment and Resources

Member Benefits

Eligible CenCal Health Members who are determined to meet medical necessity have the following covered benefits:

• Partial Hospitalization for the Treatment of an Eating Disorder
• Residential Treatment for the Treatment of an Eating Disorder

CenCal Health and the County Mental Health Plan share join responsibility to ensure access to medically necessary care for the treatment of an Eating disorder. Members who are referred to treatment by a physician or mental health provider, are evaluated and assessed by the county mental health plan to determine if member meets medical necessity for level of treatment being recommended or determine the level of treatment that is medically necessary. Once an assessment is completed with a county clinician, if determined medically necessary, the county will arrange and authorize admittance to a treatment facility. If a member does not meet medical necessity for a treatment facility, the county mental health plan will continue to monitor and treat the member in an outpatient setting through one of their county clinics.

The County Mental Health Plan arranges and authorizes medically necessary psychiatric inpatient hospitalization and outpatient specialty mental health services, including intensive outpatient programs, outpatient therapy and medication management for members who are determined to meet the county’s level of care.

CenCal Health provides comprehensive medical case management services, including coordination of care to ensure the provision of all medically necessary services, whether those services are delivered within or outside of CenCal Health’s Network.

Treatment

Procedures for the management of members with an eating disorders may include:

• Assessment and Monitoring of Member
  • Blood county and serum chemistry
  • Bone density measurement
  • Electrocardiography
  • Liver Function tests
  • Medical Evaluation
  • Urinalysis
• Nutritional Counseling (including Enteral nutrition)
• Pharmacotherapy
• Psychotherapy
  • Outpatient therapy
  • Intensive Outpatient programs
  • Partial Hospitalization programs
  • Residential
  • Inpatient Psychiatric Hospitalization

Referrals and Forms

• To refer a member to medical case management, please complete the Case Management Referral Form.
• To refer a member for behavioral health care coordination for a suspected or diagnosed Eating Disorder, please complete the Eating Disorder Treatment Referral Form.

The Behavioral Health Department will coordinate the member’s referral to the county mental health plan and follow up with the member to ensure care coordination to medically necessary care.

• To refer a member to a specialist, including a registered dietician for nutritional counseling and monitoring please complete the Referral Form.

County Providers:

For requests for collaboration, please submit an Eating Disorder Collaboration Request form.