Category: Uncategorized

Frequently Asked Services Questions

 

Verification of Benefits

What is the response time when a facility submits a Verification of Benefits to Axis?

Axis has a team consisting of 9 Claims Representatives that also verify benefits for our facility. As soon as we receive a Verification of Benefits, within minutes a claims representative will be on the phone with the insurance company. We believe in very thorough verification of benefits processes. We will cross reference all information to ensure accuracy before returning the Verification of Benefits to your facility.

On average a thorough Verification of Benefits will take about 45 minutes or less.

What can my facility expect when Axis verifies benefits for a patient?

You can expect the Axis to take every pre-caution to ensure accuracy of benefits for every level of care. We understand how paramount the Verification of Benefits process is to the entirety of billing processes. If the Verification of benefits its not done thoroughly it will have a domino affect for the patients authorizations and billing processes. We not only give you the benefits that were quoted to the Axis team, but we also provide a benefit summary which is more comprehensive.

We also provide additional information on the insurance carrier or policy and let you know what our experience has been with the insurance carrier or the specific policy. We want to make sure you understand the benefits to the fullest in order to best help your patients.

Utilization Review / Authorizations

What is a Utilization Review / Authorization?

There are 2 components of Authorizations. The first is the Pre-authorization, this process is typically done using a very specific format which Axis has refined over the years to cater to the insurance companies needs. When a patient arrives at your facility we request that your clinician fills out the entirety of the pre authorization from which we provide to you.

Once this is complete you will submit the form to the Axis Authorization team and we take it from there. As soon as we receive the authorization from the insurance company, we then notify the representatives at your facility to let them know when we will need a Utilization Review to obtain further authorization.

The Utilization Review is done anywhere from every 3 days up to being on a monthly basis. This is dependent on the level of care in which the patient is at as well as the complexity of each case. We also supply your facility with a Utilization Review template in which your clinicians will fill out and again submit to the Axis Authorizations Team. The authorizations team will then contact the insurance carrier using the provided information and obtain further authorization.

What are the benefits of having your team manage authorizations for our facility?

The Axis authorizations team is comprised of clinicians who are specially trained to work with insurance carriers. They speak the language of the insurance companies and spend countless hours researching and staying up on the changes in the substance abuse and mental health field. They also are very familiar with the medical necessity criteria for each insurance carrier.

This allows the authorizations team to advocate  for your patients and maximize authorizations for your patients.

The Axis authorizations team does not take no for an answer when it comes to helping a patient receive treatment. We have specific policies and procedures that the authorizations team follows to manage any denials and have set a new standard of overturning denials. Above this all of the individuals in our authorizations department are extremely passionate about helping individuals receive the treatment they need.

Claims Processing and Management

How long does it take to receive payments after submitting claims?

The turn around time for claims to be processed and paid is highly dependent on the insurance carrier. Axis made an analysis for the past 6 months and found that the average time it takes to receive payment on a claim is roughly 45 days from the time it is submitted to the insurance company.

Does Axis help with appeals and denials of claims?

Yes, Axis manages all aspects of claims processing including denials management. We have very defined processes for appeals and managing denials. Similar to the authorizations team, we do not accept denials lightly. We  appeal the denials using specific denial management tools to ensure that we are fighting the denial until there is some type of determination. Our staff is specially trained in managing denials and understand the insurance processes thoroughly.

This allows us to successfully overturn many denials and receive payment on claims.

Axis is follows up on all claims every other week. This allows us to catch any problems with claims processing in a very swift manner. While many 3rd party billing companies submit claims and wait for remittance from the health insurance carrier, which can be 30-60 days from the time a claim is submitted, we take a very proactive approach to the claims management processes.

By utilizing our expertise and our diligent approach we will know if a denial happens before any remittance is submitted to your facility as well as have the ability to manage claims on our end without needing to contact your facility to assist with these processes.

 

There are some important questions to address around this topic. We have asked this same question a thousand times directly to carriers. It seems there are variables per plan and it is NOT the same as billing weekly therapy visits on an ROP case vs. just the once a month visits with psychiatrist/med management on a PHP/IOP basis.

Can you bill the H0015 code on a 1500 form?

No, H0015 is a “per diem” fee and must be billed on UB04.

To determine whether you can bill the H0015 code on a 1500 form, it is necessary to consult the guidelines and policies of the specific payer or insurance company you are dealing with. Each payer may have its own set of rules regarding which services can be billed on the 1500 form and what documentation is required.

Typically, the CMS-1500 form is used for outpatient services, while the UB-04 form (also known as the CMS-1450 form) is used for inpatient services. However, specific rules may vary depending on the payer and the type of service being provided.

If not what CPT code would you use for the physician fees?


H0015 is a CPT code that describes alcohol and/or drug services. It is used to describe intensive outpatient treatment programs that operate at least 3 hours/day and at least 3 days/week and are based on an individualized treatment plan1. The code includes assessment, counseling, crisis intervention, and activity therapies or education.

To identify the correct CPT code, consider the following information:

  1. Procedure or service description: Determine the exact nature of the procedure or service provided by the physician. This may include diagnostic tests, surgeries, consultations, or other medical interventions.
  2. Documentation and guidelines: Review the documentation and guidelines provided by the American Medical Association (AMA) in the Current Procedural Terminology (CPT) manual. The manual contains a comprehensive list of CPT codes along with descriptions, guidelines, and associated services.
  3. Code selection: Based on the procedure or service description, identify the most appropriate CPT code that accurately represents the work performed by the physician. The code should align with the specific procedure, service, or evaluation provided.


Do you have to have both the UBO4 charges and the 1500 form or can you bill the physician charges without facility charges?

Facilities commonly have apprehensions as they look into this more is that they are unable to provide IOP due to being a private practice. What has normally been seen is the S9480 code is needed and has looked like it has to be billed on the UBO4.

This depends on if you can separate out a psych visit at the IOP level. It would depend on if the plan requires psych visits included with IOP per diem, which most do. Some plans allow for outside provider psych visits to be done along with a coordination of care. However, when possible, the psych visit can be billed out separately- it would be billed on a HCFA-1500 as professional. IOP services are billed on UB04 since those are “per diem” fees. In some cases, this would need to be on a different day than the IOP service.

Again, here are a few scenarios to consider:

Professional services only: If the physician provided professional services without any facility-related services, you may typically bill only the physician charges using the CMS-1500 form. The CMS-1500 form is commonly used for professional services provided in an outpatient setting.

Facility and professional services: If both facility-related services (such as hospital or clinic services) and physician services were provided, you may need to submit two separate claims. The facility charges would be billed on the UB-04 form, which is commonly used for institutional claims, and the physician charges would be billed on the CMS-1500 form.

Facility-based professional services: In some cases, certain professional services may be considered facility-based, where the physician’s services are directly associated with a specific facility. In such instances, the facility charges and the associated professional services may be billed together on the UB-04 form.


Please let us know any questions in the comment section. Axis helps with hourly consulting and partnering on licensing, accreditation, and billing as well.

Meanwhile, have a look at our coding and billing cheat sheet.

The implementation of the 988 Suicide and Crisis Lifeline in the United States is still a work in progress. Like most recently launched tools for mental health, there are some opportunities to improve upon.

  1. Insufficient Resources: One of the main concerns with crisis lifelines is the availability of adequate resources to handle the increased volume of calls. If the infrastructure and funding are not properly allocated, there may be long wait times or limited availability of trained professionals to respond to individuals in crisis.
  2. Overwhelmed System: With the introduction of a centralized emergency number like 988, there is a possibility that the system could become overwhelmed with an influx of calls. This could potentially lead to delays in response times or difficulty in reaching individuals who urgently require help.
  3. Lack of Training: Crisis hotline operators need to undergo extensive training to effectively deal with individuals in distress. If there is a shortage of trained personnel or insufficient training programs, it may lead to inadequate support and assistance for callers.
  4. Variations in Quality: The quality of crisis lifelines can vary depending on the region or organization operating them. Inconsistencies in training, protocols, and resources may result in inconsistent experiences for callers, affecting the overall effectiveness of the service.
  5. Limited Accessibility: While 988 aims to provide easy access to mental health support, there could still be certain populations that face challenges in reaching crisis hotlines. Language barriers, lack of internet access, or cultural stigma may prevent individuals from seeking help or utilizing the service.

The 988 Suicide and Crisis Lifeline are addressing some of these potential issues. Also, we would want everyone doing their own research from mental health organizations or official announcements from the relevant authorities whenever possible.

To improve the 988 Suicide and Crisis Lifeline, here are some suggestions

  1. Obtain Sufficient Funding: Allocate adequate financial resources to ensure the lifeline has the necessary infrastructure, staffing, and training programs to handle the expected increase in call volume. Adequate funding will help address issues such as long wait times and limited availability of trained professionals.
  2. Comprehensive Training: Provide extensive and ongoing training to crisis hotline operators. This training should focus on active listening, empathy, crisis intervention, and suicide risk assessment. Ongoing education and support can help maintain the quality of service and ensure operators are well-prepared to handle diverse situations.
  3. Network Expansion: Collaborate with existing mental health organizations, crisis centers, and local service providers to expand the network of support. Establish partnerships with community organizations, hospitals, and mental health professionals to ensure a continuum of care beyond the immediate crisis call.
  4. Multilingual and Culturally Competent Services: Recognize the diverse needs of the population and ensure that crisis hotline services are available in multiple languages. Provide training and resources to ensure cultural sensitivity and competence when assisting callers from various backgrounds.
  5. Public Awareness Campaigns: Launch public awareness campaigns to promote the availability and importance of the 988 Lifeline. Educate the public about the signs of mental health crises, the role of the lifeline, and the confidentiality and non-judgmental nature of the service. This can help reduce stigma and encourage individuals in distress to seek help.
  6. Robust Referral System: Establish a robust referral system to connect callers with appropriate follow-up care and resources. Maintain partnerships with local mental health providers, hospitals, and support services to facilitate smooth transitions from crisis intervention to ongoing treatment.
  7. Continuous Evaluation and Improvement: Regularly assess the effectiveness of the 988 Lifeline through data collection, user feedback, and evaluation of outcomes. Use this information to make necessary adjustments and improvements in service delivery, training protocols, and resource allocation.
  8. Research and Innovation: Support research initiatives to further understand the factors contributing to mental health crises and suicide risk. Invest in technological advancements and innovative approaches to enhance the lifeline’s capabilities, such as AI-assisted screening or chat-based support options.

Treatment providers can effectively utilize the 988 Suicide and Crisis Lifeline in the following ways

  1. Educate Patients: Inform patients about the availability and importance of the 988 Lifeline as part of their treatment plan. Emphasize that it serves as an immediate resource for crisis support when they are unable to reach their provider directly.
  2. Crisis Intervention Support: If a patient is experiencing a mental health crisis or suicidal ideation, encourage them to contact the 988 Lifeline for immediate assistance. Emphasize that crisis hotline operators are trained professionals who can provide support, assess risk, and connect them with appropriate resources.
  3. Collaborate with Lifeline Operators: Establish a collaborative relationship with the 988 Lifeline operators. Communicate the services and resources your treatment facility offers, such as specialized programs, therapy options, or inpatient care. This can help ensure a smooth transition of care for individuals who require ongoing treatment beyond the crisis intervention.
  4. Provide Information and Referrals: Share relevant information about your treatment services and any specific requirements (e.g., insurance coverage, age restrictions) with the 988 Lifeline. This enables them to provide accurate and up-to-date referral information to callers who may benefit from your services.
  5. Share Crisis Plans: If a patient has a crisis plan in place, including contact information for their treatment team, encourage them to share this information with the 988 Lifeline during their call. This can help ensure that crisis hotline operators have a comprehensive understanding of the individual’s situation and can make appropriate referrals or provide necessary information to the treatment team.
  6. Follow-Up and Coordination: After a patient has contacted the 988 Lifeline, make sure to follow up with them to assess their well-being and discuss any additional support they may need. Coordinate care and communicate with the crisis hotline operators when appropriate to ensure continuity of care.
  7. Stay Informed: Stay updated on the latest developments and resources related to the 988 Lifeline. This includes being aware of any changes in protocols, resources, or referral pathways. Regularly communicate with the 988 Lifeline administrators to maintain a strong working relationship.

By engaging with the 988 Suicide and Crisis Lifeline, treatment providers can enhance the support they offer to their patients during times of crisis and ensure a collaborative approach to mental health care.

What are some signs of a friend or family member struggling with mental health or substance abuse?

Recognizing red flags can help identify when someone may be in need of help and could benefit from reaching out. Here are some common warning signs:

  1. Verbal Cues: Pay attention to any direct or indirect statements that express feelings of hopelessness, worthlessness, or a desire to die. Examples include saying, “I can’t go on anymore,” “Life isn’t worth living,” or “I wish I were dead.”
  2. Drastic Mood or Behavior Changes: Notice significant shifts in mood, behavior, or personality, especially if they seem out of character for the person. This can include sudden withdrawal from social activities, increased irritability, or extreme mood swings.
  3. Isolation and Withdrawal: If someone starts isolating themselves or withdrawing from social interactions, it may indicate that they are struggling. They may become increasingly distant from friends, family, or activities they once enjoyed.
  4. Loss of Interest: A significant loss of interest or pleasure in previously enjoyed activities can be a sign of depression or emotional distress. This could include a decline in hobbies, sports, socializing, or work engagement.
  5. Reckless or Risky Behavior: Engaging in reckless or self-destructive behavior, such as substance abuse, excessive drinking, or participating in dangerous activities, may indicate a cry for help or an inability to cope with underlying emotional pain.
  6. Giving Away Belongings: If someone starts giving away their possessions, making statements about not needing things anymore, or putting their affairs in order unexpectedly, it could be a sign that they are contemplating suicide.
  7. Changes in Sleep Patterns: Noticeable changes in sleep patterns, such as insomnia or excessive sleeping, can be indicative of emotional distress or mental health issues.
  8. Expressions of Feeling Trapped or Burdened: If someone talks about feeling trapped, burdened, or as if they are a burden to others, it may suggest a sense of overwhelming stress or despair.
  9. Sudden Improvement: Sometimes, a sudden improvement in mood or demeanor after a period of significant distress can be a cause for concern. It could indicate that the person has made a decision to end their life and has found some relief from the internal struggle.
  10. Previous Suicide Attempts: Individuals who have previously attempted suicide are at a higher risk. If someone has a history of suicide attempts, any signs of distress should be taken seriously.

Possible situations for those needing to use the 988 Suicide and Crisis Lifeline

  1. A teenager struggling with overwhelming stress and depression calls a crisis hotline after feeling isolated and contemplating self-harm. The trained operator listens empathetically, assesses the level of risk, and connects the teenager with local mental health services for immediate support. The hotline’s intervention saves the teenager’s life and leads to ongoing treatment.
  2. A family member calls a crisis helpline concerned about their loved one’s sudden withdrawal, mood swings, and expressions of hopelessness. The helpline operator provides information on mental health resources, including therapy options and support groups, and guides the caller on how to have a conversation with their loved one about seeking professional help. This guidance helps the family take necessary steps toward getting their loved one the support they need.
  3. A veteran experiencing post-traumatic stress disorder (PTSD) symptoms and suicidal thoughts reaches out to a crisis hotline specifically dedicated to supporting veterans. The operator, trained in military-related mental health issues, provides a safe space for the veteran to express their concerns, offers emotional support, and connects them with specialized VA resources and counseling services.
  4. A college student in distress due to academic pressure, relationship difficulties, and feelings of isolation contacts a crisis hotline specifically designed for students. The hotline operator engages in active listening, validates the student’s experiences, and provides guidance on managing stress, improving self-care, and accessing campus mental health services. This intervention helps the student regain a sense of hope and connect with appropriate resources.
  5. A person who has lost a loved one to suicide and is struggling with their own grief and emotional well-being reaches out to a crisis helpline specializing in bereavement support. The helpline operator provides a compassionate ear, validates the person’s emotions, and offers resources for grief counseling and support groups. This assistance helps the individual navigate their grief journey and find a supportive community.

While the specific stories may vary, crisis helplines play a crucial role in saving lives, providing emotional support, and guiding individuals toward the help they need.

To obtain accurate and up-to-date information regarding ChampVA billing codes, condition codes, occurrence codes, and value codes for behavioral health RTC, PHP, and IOP claims. It can be best to consult the official resources provided by ChampVA.

Every plan is different, and they can provide you with the most current and accurate information related to their billing and coding requirements.

What are the ChampVA Billing Codes for Behavioral Health

ChampVA follows the standard coding systems for billing behavioral health services. The most commonly used coding systems for behavioral health services are the Current Procedural Terminology (CPT) codes and the Healthcare Common Procedure Coding System (HCPCS) codes. Here are some common CPT and HCPCS codes that may be used for billing behavioral health services with ChampVA:

CPT Codes:

  • 90791: Psychiatric diagnostic evaluation
  • 90832: Individual psychotherapy, 30 minutes
  • 90834: Individual psychotherapy, 45 minutes
  • 90837: Individual psychotherapy, 60 minutes
  • 90846: Family psychotherapy without the patient present
  • 90847: Family psychotherapy with the patient present
  • 90853: Group psychotherapy
  • 96101: Psychological testing evaluation services
  • 96118: Neuropsychological testing
  • 99213: Evaluation and management (E/M) service for an established patient, 15 minutes

HCPCS Codes:

  • H0031: Mental health assessment, by a non-physician
  • H0035: Partial hospitalization (PHP) services, per diem
  • H0036: Community-based psychiatric rehabilitation and support, per 15 minutes
  • H2011: Crisis intervention, per hour
  • H2035: Alcohol and/or drug services, group counseling
  • H0004: Behavioral health counseling and therapy, per 15 minutes
  • S9484: Behavioral health, counseling and/or therapy provided via synchronous telecommunication
  • T1015: Mental health case management

The specific codes used for billing behavioral health services may vary depending on the nature of the service provided, the duration, the level of care, and other factors. Consult the most recent version of the ChampVA provider manual or contact ChampVA directly for the most accurate and up-to-date information on billing codes specific to their program.

How to become credentialed with ChampVA as a healthcare provider?

Providers need to go through a credentialing process. Here are the general steps involved:

  1. Determine eligibility: First, ensure that you meet the eligibility criteria to participate as a provider in the ChampVA program. This typically involves having the necessary licenses, certifications, and qualifications to provide the specific healthcare services covered by ChampVA.
  2. Complete the application: Obtain the provider application form from ChampVA. You can typically find the application form on their official website or by contacting their provider enrollment department. Fill out the application form accurately and completely, providing all the required information.
  3. Gather required documentation: Along with the application form, you will need to submit various supporting documents. These may include proof of your professional qualifications, such as copies of licenses, certifications, and educational degrees. You may also need to provide documentation related to your professional liability insurance, practice locations, and other relevant details.
  4. Submit the application: Once you have completed the application and gathered the necessary documentation, submit the application and supporting documents to ChampVA according to their specified instructions. This is typically done either electronically or by mail, depending on their preferred method.
  5. Follow up and respond to inquiries: After submitting your application, be prepared to respond to any additional requests for information or clarifications from ChampVA. They may contact you if they require any further documentation or have questions regarding your application.
  6. Await review and decision: The ChampVA provider enrollment department will review your application, verifying your credentials and evaluating your eligibility to participate in the program. The review process can take some time, so it’s important to be patient.
  7. Notification of credentialing decision: Once the review process is complete, you will receive a notification from ChampVA regarding the status of your credentialing application. If approved, you will be provided with further instructions on the next steps to become an enrolled provider with ChampVA.

Specific requirements and processes for credentialing with ChampVA can be dependent on each provider. Providers can also contact the enrollment department directly to obtain the most accurate and up-to-date information on their credentialing process and any specific requirements they may have.

The specific number of patients allowed in either a Partial Hospitalization (PHP) or Intensive Outpatient Program (IOP) for behavioral health can vary depending on the state, program, facility, and the resources available.

However, there is no universally fixed limit on the number of patients that can participate in an IOP. Generally, state insurance agencies nor insurance carriers do not have a requirement.

Here is what we will try to answer:

1. How many patients are allowed to be in PHP/IOP together?

2. Is reimbursement higher for per diem or per session?

2. Can S9480 ever be billed on a CMS 1500 without the revenue code or must it always be on UB04?

3. A little clarity on how to bill using the S9480 code…for example if a program had 3 patients in treatment and they met for 3 hours a day 3 days a week. What would that look like in terms of insurance billing?

There are a lot of variables to insurance billing, each policy of a plan needs to be vetted and checked for limitations and criteria

The capacity and census of a PHP/IOP can depend on factors such as the size of the facility, the staffing levels, the treatment philosophy, and the specific needs of the patients. Some PHPs/IOPs may have smaller groups with fewer patients to allow for more individualized attention and a more intimate therapeutic environment. In contrast, others may accommodate larger groups if they have the resources to support it.

Although the reimbursement rate for IOP (S9480) should not be the same as individual, family, group therapy (90837/90847/90853) because it’s per diem and these codes add up to the same clinical hours to be about 3 hours a day, reimbursement is sometimes equal. Many insurance carriers do not allow for multiple services for therapy to be billed on the same day regardless of modifiers that can be used to specify this. Providers must bill for the actual services provided essentially.

S9480 will generally be billed on UB04 since it is a per diem fee although some insurance carriers that carve out with UHC will require HCFA/CMS 1500. It is unlikely, but there could be a published list of those requiring S9480 be billed HCFA/CMS 1500.

Insurance carriers often are not allowed to inform providers how to bill or which codes to use, unfortunately.

Carriers change billing requirements often, and finding up-to-date information on specific insurance carriers and their billing requirements can be challenging. Each insurance carrier may have their own policies and guidelines regarding billing procedures, including which forms should be used for specific services.

To obtain accurate and current information on insurance carriers that require S9480 (which appears to be a Healthcare Common Procedure Coding System code for PHP/IOP Psychiatric Services) to be billed on the HCFA and CMS 1500 forms, we can help, and recommend reaching out to the specific insurance companies or consulting the provider manuals and billing guidelines provided by those carriers.

On June 6th, 2019, Anthem, Inc. announced that they are in the definitive stages to acquire Beacon Health Options, Beacon currently serves more than 36 million individuals across all 50 states, and 3 million of those under comprehensive risk-based behavioral programs.

“Our member-focused, integrated clinical care model helps individuals and their families cope with their physical and behavioral health challenges. Together, we will expand access and enhance the quality of care for our mutual members. I am proud of the talented and committed team at Beacon, and we look forward to our future with Anthem.”–Russell C.Petrella, Ph.D., Beacon Health Options President and CEO

Anthem didn’t disclose a price it is paying Bain Capital Private Equity and Diamond Castle Holdings for Beacon Health, which is privately held. The acquisition is expected to close in the fourth quarter of 2019. However, this is a great opportunity for Anthem to utilizing Beacon Health Options, already stellar business model, not to forget they are the country’s largest independently held behavioral health provider.

“As Anthem works to improve lives, simplify healthcare and serve as an innovative and valuable partner, we’re focused on providing solutions that address the needs of the whole person,” -Gail K. Boudreaux, President and CEO, Anthem

The acquisition will offer the opportunity to combine both successful business models to diversify the health services and deliver market-leading integrated solutions. Progressing towards a stronger portfolio of specialized services, improved clinical expertise, and ability to offer broader provider networks and establishing positive relationships.

“We are excited to partner with Anthem to serve the behavioral health needs of more than 60 million Americans,” –Russell C. Petrella, Ph.D., Beacon Health Options President and CEO

Once the acquisition is complete Beacon, combined with Anthem’s behavioral health business, will operate as an integrated team within Anthem’s Diversified Business Group. Russell C. Petrella, Ph.D., Beacon Health Options President and CEO, as well as other key members of Beacon’s senior team, will join Anthem’s Diversified Business Group to lead the efforts to offer innovative behavioral health solutions and further expand this business.

“With an extensive track record in behavioral health, Beacon fits well with our strategy to better manage the needs of populations with chronic and complex conditions, and deliver integrated whole health solutions. Together with Beacon, we will enhance our capabilities to serve state partners, health plans and employer groups as they seek to address consumer behavioral health needs.” -Gail K. Boudreaux, President and CEO, Anthem

We are excited and believe this is very significant as more insurers are working on addressing the determinants of care for mental illness that fall outside of the traditional medical care. One out of every five adults suffers from mental illness, and is only increasing, according to the National Institute of Mental Health.

What are your thoughts on this acquisition? Is this good or bad, why so?

Now that it’s officially the “Holiday Season”, if you’re like most people I know, as much as we would like to be in good spirits, we all know the stress it can cause. It doesn’t make it any better when there are those already dealing with a mental health illness. But it doesn’t have to be so bad after all, especially if food is involved, right?

We know it’s fall time when the weather gets cooler, the colors outside change, and of course we begin to hear Christmas music everywhere we go, even if Halloween was just two days ago. The joyous anticipation towards the holidays is what most just can’t wait for all year long.

Grandma’s sweet smelling baked goods, cooked to perfection turkey, and all the sides one can ask for while enjoying it all with your loved ones and friends. Making your plate look like Splash Mountain at Disneyland, then knowingly preparing for the ultimate food coma that will inhibit your body for at least two hours on the couch while watching football or family movies.

Ahhh yes its time to eat everything in sight now, and start fresh all over again by going to the gym on January 1st. That’s generally the plan, right?

Well, what if I told you, you can incorporate five certain foods during the holidays that can actually help with your mental health, would you eat it? The mental health benefits of certain holiday foods go beyond the food memories that make you feel good. The nutrients in these five foods can deliver a solid boost to your mood, which is something we can all use during the stressful holiday season.

1. Pumpkin

This may be the most known holiday food used, but did you know that pumpkin contains minerals that boost brain function?

Pumpkin contains Lutein and Zeaxanthin, which are both excellent nutrients for boosting memory recall in both younger and older adults.

The pumpkin seeds contain the amino acid Tryptophan and help your brain produce serotonin, a chemical known to boost your mood and give you an overall content feeling. So eat as much pumpkin pie as you can, well in moderation I guess.

2. Cinnamon 

When I think of Thanksgiving or Christmas, my first thought is the smell of cinnamon sticks as I walk into my Aunts house I visit every year.

Cinnamon adds warmth to the flavor in teas, cider, oatmeal, bread, baked fruit and veggies, and more. Try making cinnamon roasted almonds, cinnamon rolls which are always a kid favorite, or you can get your healthy on and try making a cinnamon spiced pumpkin hummus, and incorporate two great holiday foods.

But the benefits are even better by helping in stimulating your brain, and also helps regulate blood sugar, which contributes to an overall steady mood.

3. Turmeric

Turmeric is considered a wonder spice for so many health conditions including reducing the symptoms of depression. Tumeric has powerful antioxidant and anti-inflammatory properties also which is great for your overall well being.

There are many ways you can use Tumeric. Try it by spicing up your chicken or turkey dish, or add it to your soups, or just simply add it to your coffee in the morning. Don’t worry, your body will thank you later. If you do use Tumeric in your dishes, remember that although it does taste very delicious, a little bit goes a long way.

4. Apples

You can find apples in your local store all year long, but September and October are the best months to get apples. Over the past several years, nutrition research has focused on the effects of apple consumption and its relationship to providing protective neurological benefits.

Registered Dietitian Jenn Fillenworth, MS, RD, says, “Since apples have a high phytochemical profile, they are excellent at preventing DNA damage, regulating hormones, and reducing oxidative damage,” she explains. “All of these things are directly related to supporting good mental health.”

You can use apples in any salad, or a salsa dip, also try baking some apple chips in the oven to eat with your apple salsa dip.

5. Acorn squash

Acorn squash is a small type of winter squash with a light yet slightly sweet flavor. Acorn squash is one of the most nutrient-dense squash varieties and contains higher amounts of antioxidants than other squash in general. It contains magnesium, which is an important nutrient for helping with depression and anxiety.

“A recent study shows that increasing magnesium in the diet may lead to a significant decrease in symptoms of depression and anxiety regardless of age or severity of their depression,” -Registered Dietitian Jenn Fillenworth, MS, RD

Try stuffing it with some cinnamon and fruits such as apples or peaches, or for your meat lovers try stuffing some of your favorite meats. I guarantee it will taste great while helping to decrease anxiety and depression.

I hope this was helpful and gives you some ideas for taking a healthy choice dish for your next family holiday party. With the well-known stressors that can be triggered during the holidays, we can all use anything and everything that can help remedy the chaos during this busy yet wonderful holiday season.

 

 

Did you know that nearly one out of every five Americans had a mental illness last year? Denying coverage is now being looked at deeper than just a financial issue, as some see it as a human rights issue.

Families are suffering from the strict system placed on behavioral health insurance processes. A system that fails the needs of people who need it the most, because of not meeting insurance company’s, “medical necessity”, clause.

Without a reasonable doubt, this is more than a concern for so many Americans who suffer from behavioral health illnesses and can’t seem to get the adequate treatment needed to overcome this difficult roadblock.

A psychiatrist once said,

“Before I decided to specialize in psychiatry, I assumed a person in need of mental health care would have the same access to treatment one has for medical conditions like kidney stones, pneumonia or seizures. Instead, mental health patients and their providers face a mountain of bureaucratic obstacles that other patients are spared.”

Imagine being a doctor, and having to tell someone or even a child who desperately needs treatment, that they aren’t considered depressed enough, or their presenting conditions do not meet the most critical states of mental illness in order to be treated.

With adolescent mental health illnesses on the rise, this has to be one of the most ignored issues that we face in America today. According to the new report, diagnoses of “Major Depressive Disorder”,  have risen to over 30 percent since 2013, and now affects an estimated 9 million commercially insured Americans.

Teen depression rates are increasing so rapidly, if we don’t figure out a better solution, we will be headed for an array of consequences. The Centers for Disease Control and Prevention estimates there were 72,000 deaths from opioid overdoses last year and more than 43,000 suicides reported in 2017.

Nowadays the requirement to even be admitted into a psychiatric facility is set so high, it can be very frustrating when attempting to get prior authorization for treatment. Even if patients have just attempted suicide, shockingly many insurers still require prior authorization by phone before they can step foot inside of the facility.

“Even in spite of the fact that we’re in the midst of the biggest public health crisis of our time of overdose and suicide, we as a nation have yet to come to grips with this in the way that it needs to be,” – Former congressman and mental health care advocate Patrick Kennedy. 

For any other medical hospitalization, nothing is really required and the insurers trust the judgment of the providers. Not the same for psychiatric hospitalizations and treatment centers. In the U.S., denials for mental health care occur three times as frequently as denials for general medical care.

The process of finding and funding adequate mental health treatment is a very daunting task, and most times insurers will simply deny treatment initially knowing that most people are going through so much that will won’t challenge denials of care, leaving them feeling lost and confused and only adds to the stress they are already dealing with.

It’s time to make mental health illness a priority in not only fighting the stigma but also the discrimination set forth from the insurance companies. This system continues to get worse and totally does everything they can to stop treating those who need it, simply based on the fact that they are not considered depressed enough, or suicidal enough to please their extreme criteria. Ask yourself, why isn’t mental health illnesses being looked at as serious as cancer, diabetes, or cardiovascular diseases?

It’s quite frustrating when just 10 years ago, a law passed called the  Mental Health Parity and Addiction Equity Act, also known as the Federal Parity Law. The law requires most insurers to cover illnesses of the brain, such as depression or addiction, no more restrictively than they cover illnesses of the body.

“There are still tons of roadblocks on the policy side and, frankly, in spite of the fact Congress thinks they’ve appropriated some gargantuan amount of money, it still represents less than one-fifth of what we were spending on HIV/AIDS during the AIDS crisis when we were losing far fewer people than we’re currently losing today,” – Patrick Kennedy

In a recent study conducted by a private research company and Georgetown University, researchers found the following listed below.

  • Insurers regularly denied coverage to people with pre-existing mental or substance use conditions;
  • Insurers imposed a 20 to 50 percent increase in premiums for people with a history of mental health or substance use conditions;
  • Insurers offered superficial coverage that did not meet essential needs; and
  • Insurers actively created barriers and limited access to mental health and substance use treatment.

The only way we can see any change is by standing up and speaking out on unjust insurance denials and registering a complaint with your health plan. The more we do this, we can help pressure elected officials, insurance commissioners, and the attorneys general to enforce federal and state parity laws in favor of the patients who need the attention and treatment their insurance plan should be covering.

Nothing will ever change if we don’t speak up and hold insurance companies accountable. We must demand equality for those with mental health and addiction challenges. We cannot stand idly by while insurance companies break the law, at the expense of American families.

Help for Mental Illnesses. Get Immediate Help. If you are in crisis and need immediate support or intervention, call, or go the website of the National Suicide Prevention Lifeline (1-800-273-8255). Trained crisis workers are available to talk 24 hours a day, 7 days a week.

Have questions or need help with insurance claims and or denials, we are always here to answer or help in anyway possible.