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Ask the Mental Health Expert Archives 2001-2004

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3rd Party Reimbursement

Q. Is there any literature documenting third party payer reimbursement linkage to DSM diagnosis?

A. I could not find any studies directly linking third-party payer patterns with DSM psychiatric diagnosis. However, there are several articles you may want to read on related issues. For example, Bailine ( Journal of ECT, Dec. 1998, pp. 255-8) studied reimbursement and documentation issues in an ambulatory ECT program, focusing on problems third-party payers have with finding necessary data in the chart.

Also, Newcomer et al ( Journal of the American Geriatric Society, Feb. 1999) have a study entitled, "Misclassification and selection bias when identifying Alzheimer's disease solely from Medicare claims records" that may bear on your question. Finally, you may want to see the letter by G. Sigman, entitled, "How has the care of eating disorder patients been altered and upset by payment and insurance issues?" in the Journal of Adolescent Health, Nov. 1996, pp. 317-18.

January, 2001

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