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Thread: Who pays for involuntary psychiatric holds?

  1. #1
    Member
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    Default Who pays for involuntary psychiatric holds?

    Who pays for involuntary psychiatric hold (aka 5150, Baker Act, sectioning, etc)? Let's say Bob is placed on a 72 hour old; does the bill go to his health insurance? What if he has no insurance; does he need to pay out of his own pocket? Does the hospital get reimbursed by the state or just write it off? Does it matter if after observation the staff determine he didn't warrant involuntary commitment?
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  2. #2
    Oliphaunt
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    Default Re: Who pays for involuntary psychiatric holds?

    Usually, your health insurance will pay for all or part of a psychiatric stay; it depends on the coverage. If your coverage doesn't include psychiatric stays, or you don't have health insurance, you would need to sign papers upon admission that you will pay for the services, usually on some sort of payment plan.
    If you don't have health insurance, you can also talk with a social worker about getting Medicaid to cover part or all of the cost.

    (I'm an EMT with a private ambulance company, and I do many, many psych transfers.)
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  3. #3
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    Default Re: Who pays for involuntary psychiatric holds?

    Surely if it's involuntary, no one would expect me to sign a paper agreeing to pay for it? Even if I did, and they subsequently determined that I did, indeed, suffer from mental disability, how could they collect? After all, they themselves may have determined that I was incompetent to make decisions at the time I signed.

  4. #4
    Oliphaunt
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    Default Re: Who pays for involuntary psychiatric holds?

    MyOwnWorstEnemy, that question would get a big old 'I dunno' from me.
    I'm not involved in insurance and payments; this is just coming from what I've seen and heard during admissions.
    We had a patient a couple weeks ago with no insurance, and there was some question of whether or not we'd even be doing the transfer, because they didn't qualify for Medicaid for some reason, and there was some question of payment.
    I don't know all the specifics; this is just what I get in my call information - we have to verify before we go that the accepting facility is actually accepting them, due to insurance coverage, or the lack thereof.
    Depending on the patient, a parent or spouse may be the one to sign them in. Other times, it would be a social worker.

    In the case of Emergency Petitions, in which a patient is in immediate danger to themself or others, and what most involuntary commitments are, most facilities will accept them, regardless of insurance.
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  5. #5
    Stegodon
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    Default Re: Who pays for involuntary psychiatric holds?

    We (two psychologists) assume that the county foots the bill for a hold for observation (initially approved by the county mental health director's designee) and that the state picks it up if a judge orders an involuntary commitment.

    We think it's possible that a patient's insurance might get used if s/he went in voluntarily and then her status changed. However, I've never heard involuntary patients complain about their insurance being billed, and I think I would have.
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  6. #6
    Stegodon Boozahol Squid, P.I.'s avatar
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    Default Re: Who pays for involuntary psychiatric holds?

    I manage the admissions department of a private hospital in North Carolina that accepts plenty of involuntary commitments.

    For our facility, we verify and get authorization for coverage through a private insurer for any involuntary admit. We end up swallowing any difference between our costs and what the insurer pays. If they don't have behavioral insurance, we ship them to the state facility, where the state foots the bill.

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