TREATMENT GUARANTEE
The following shall set out the terms of Eating Disorder Solution’s (“EDS”) Treatment Guarantee. This Treatment Guarantee shall apply to those individuals meeting the following eligibility requirements and are subject to the terms and conditions as set forth, or otherwise to the discretion of EDS which may be modified from time to time.
ELIGIBILITY REQUIREMENTS
In the event that a client experiences a significant setback[1] shall occur during the first nine months of your successful completion [2] of our full continuum of care treatment program, for a minimum length of 75 days of treatment, we will cover your costs to attend our 75 day program for a second time. A 75 day treatment stay shall mean 75 individual days completed in a level of care where services were delivered and received, and reimbursed by insurance.
The following Conditions Precedent must be met prior to being able to qualify for readmission to a Residential Treatment Program for a second time:
- Clients must have completed residential and outpatient (php/iop) levels of care treatment with EDS. This requires the individual to have completed a residential, PHP and IOP level of care, with no denials or lapses in coverage from their insurance provider.
- Client has made all payments related to his/her first treatment program; no patient balance outstanding and client is up to date on all payments.
- Client must not have any delinquent balances for previous treatment episodes that are owed to EDS or any of its affiliates.
- Client’s setback must have occurred no longer than one year from the Client’s final discharge date from IOP.
- Client must have complied with all discharge plans and continued treatment with their aftercare plan as set by the EDS treatment team.
- Client must have called the Admissions department with the purpose of seeking readmission to a EDS Treatment Program no later than nine months after their final discharge date from an IOP level of care.
Furthermore, the following limitations apply to this offer:
- Any required travel expenses, third party physician fees for non-EDS medical personnel, or prescriptions are excluded from this offer, and must be paid upon re-admission. Any outside costs incurred while in treatment or after receiving treatment will be the Client’s responsibility.
- This Treatment Guarantee covers services rendered by the facility and staff, but does not include any services rendered by other professional(s) in the community including, but not limited to, emergency room visits, urgent care visits, hospital admissions, outside lab work, or prescription medications. These costs must be paid by Client or applicable insurance.
- Travel is not covered as part of this agreement, any and all travel to and from an EDS facility is the sole responsibility of the Client.
- This offer is non-transferable, may only be used once, and the complimentary 75 days of treatment must be used consecutively and within nine months of Client’s discharge date.
- Any unauthorized departure from the treatment facility, administratively discharged or discharge Against Medical/Clinical Advice (AMA) prior to the completion of the entire program will result in the forfeiture of any remaining balance of days.
- EDS will make every effort for a reasonable accommodation on facility placement based on the client’s wishes, however; we reserve the right to offer whichever program is most clinically appropriate. If at or around the time of the setback there are no current vacancies, EDS in its sole discretion, may postpone the admittance to a date when there is availability in one of its corporate-owned facilities.
- The qualifying stay for the guarantee must be a paid stay.
EDS retains the right to refuse a second Residential Treatment period to an individual who was previously discharged for:
- Disruptive behavior;
- Harm to other clients; or
- Noncompliance with our Residential Procedures.
EDS retains the right to end a client’s second residential treatment period, at any time during the period, for any of the following reasons:
- Disruptive behavior,
- Harm to other clients,
- Non-compliance with our residential procedures,
- A higher level of care is needed, as determined by the healthcare providers, or
- If, in the opinion of the administrator, the continuation of care of the Client would not be therapeutic for the Client or negatively impact other clients receiving services at the facility, the administrator’s decisions are final and there is no process of appeal.
[1] Significant setback shall mean behaviors that are ongoing, and not be a one-time event for which the client is presenting in a medical condition that is either the same or worse than when originally admitted
[2] Successful completion of treatment means completing all necessary levels of care consistent with your treatment plan.