Within Health is a virtual, app-based and online eating disorder treatment program founded by Dr. Wendy Oliver-Pyatt, who previously founded Oliver-Pyatt treatment center. It offers customizable IOP and PHP and treats adolescents and adults of all genders and body types.
Within’s treatment program offers individual and group therapy, experiential and movement therapy, telepsychiatry, remote physical health monitoring via supplied devices (numberless scales, blood pressure cuff, and thermometer), nursing, meal support groups with food brought to your door, therapeutic outings, and both app and text-based clinical support.
They accept both insurance and self-pay, and are often able to arrange individual Single Case Agreements (SCA) with insurance companies who otherwise wouldn’t cover Within. Patients who don’t have insurance or who may not be able to use their insurance for treatment at Within have the right to receive a “Good Faith Estimate” explaining how much their care will cost.
So far Within is licensed in the following states, with more to come:
Has anyone ever been assessed at within and denied for either medically instability or intensity of behaviors? What is their protocol for that?
usually they send you to res or hospital until your health is a little better
Could anyone provide an updated review for either the php or iop programs? I am scheduling an assessment there and want to know what to expect? Also what is their criteria for determining level of care. I am afraid they might recommend residential but that is not ideal for me right now.
I’m in WA and have WA/OR BCBS PPO. Reading the reviews here I’m wary of the financial cost but really need a virtual option due to having to work. Do they work on the SCA themselves? I just would want to make sure I know what is happening up front and not be left with an enormous bill?
I have BCBS PPO of Pennsylvania but my plan covers any state of BCBS PPO. I have a financial call with them today after they reviewed my insurance so we will see
Tw: tubes
Has anyone done within with a PEJ or PEG tube?
I have a tube for medical reasons and wondering if they will work with me. I’m going to call just wondering if anyone here has experience with them.
So I did Within Health from maybe April to June of 2024. I had met my out of pocket max for my PPO plan BCBS MA so they didn’t charge me up front. But then my insurance only wanted to pay $180/day for PHP. Now I am fighting a $25k bill. I appealed internally and then did an external appeal through the Mass department of insurance. My case has been assigned but now it’s been almost a year. Can anyone recommend a health insurance lawyer?
Oh my gosh! That’s horrible. I was there the same time as you. Wonder if we crossed paths. Unfortunately, you are not the only one that has said similar things about the billing office and having to fight. Wishing you so much luck and aupport!
Reach out to the attorney general in your state- I had to do the same thing and they can help with legal support.
Unfortunately they are permitted to balance bill for out of network care. If they were nice, they would agree to take what insurance paid and leave you alone but from a business perspective they rely on balance billing to make up for how little insurance reimburses.
Has anyone had issues with readmission to within with having a balance from a prior admission. I just need support
Im dealing with this right now… its tough. Wishing you the best of luck figuring it out
I had the same issue, even though they are now in-network
does anyone have feedback on HOW accountable they hold you for portioning and completing? I qualify for res and am needing high level of support to get back on track but truly don’t want to pick up my life again! thanks
You need to have a lot of your own motivation to do any program virtually. Portioning is done on camera. The CP’s do their best to help you complete meals. Honestly, if you qualify for res they’ll likely tell you that you need to do res.
Question: if I have an outpatient dietitian and therapist, would I still be able to work with them during my time with Within?
Yeah, I did. The only thing is that some insurance companies may not pay for Within and your outpatient stuff on the same day, so you may need to either pay out of pocket for outpatient or schedule your appointments on days off from Within. They were really good about staying in touch with my outpatient therapist and dietitian and making sure everyone was on the same page.
The way they do billing is unusual, thought it might be helpful to share since I don’t think it would come up immediately unless you either asked specific, leading questions in the initial info call or got through the whole process and were about to admit.
As mentioned, within is only In-Network with one insurance plan (I think it was South Carolina blue cross?), but they will try for SCAs with other insurance companies to have services covered in-network. Not sure how successful they are with that. MOST insurance coverage for them would fall under Out of Network benefits if you have those on your plan. They will deal with insurance directly – I.e they will submit the documentation for coverage directly to your insurance and go back and forth with them for the coverage and amount so you don’t have to try to get reimbursed yourself. However, this process means they request a significant amount of money up front upon admission so that they have a pot of your money to pull from to cover balance billing (if that comes up). Essentially, they want a minimum amount of money reimbursed per day for IOP and a minimum for PHP (I think it’s $600 for IOP and $900 for PHP), so if your insurance out of network benefits reimburse them that amount or more – they won’t need to balance bill you. If insurance reimburses less than that per day, they pull money from the pot of money you’ve paid up front to cover the difference in what your insurance will cover and their minimum per day. Outside of that, if you have an out of network deductible, they will collect that up front in full on top of the amount they collect for balance billing. The back and forth with insurance can take weeks, so they want you to pay enough to cover that amount of time. So if you wanted to do PHP 5 days a week, they’d collect $220 (I think is the amount) per day for the first 5 weeks of programming which is based on the average amount of balance billing they have to do once the insurance reviews are completed – $5500 up front PLUS any unmet out of network deductible, so if you haven’t met your $4000 out of network deductible when you try to admit, they will require that amount from you up front as well. This amounts to a Bank of $5500 for balance billing + $4000 deductible up front. Reminder, this is a hypothetical amount based on a certain level of care, # of days, insurance plan, etc. so it’s different person to person. That $5500 might be eaten up (ha) faster if your insurance covers less than the average balance billed…or, you might not have to pay anything if your insurance covers more than their minimum per day for each level of care. They will reimburse your balance billing bank if it is unused, they will NOT reimburse your deductible that you pay, even if you over pay it due to other claims processing at the time of admission.
This is sickening… so few people have $5500 cash available for this sort of thing. I have never had insurance that has out of network benefits at all, I’ve only had HMO via my dad’s work when I was younger and govt insurance once I aged out. It really pisses me off that treatment centers are almost all for-profit businesses. They should be nonprofits that charge what it takes to run their programs, which would still not be accessible to everyone but would be for more people. I hate the slogan “eating disorders are not a choice but recovery is”. The girls who echo this on social media are 22 and on daddy’s PPO, bouncing between res and PHP for as long as they need. I have never seen someone on govt insurance whose choices are a restrictive, punitive IP unit that weight restores with minimal therapy (I genuinely think it’s cruel not to have at least a 15 min check in, ideally a full session on weekdays, with a licensed therapist or dietician at the IP/Res and even PHP level of care and should be illegal to bill insurance an IP rate without this) and an “outpatient team” consisting of the few providers their insurance covers that have minimal to no ED experience and no OP dietician with no in between say this phrase. There are definitely people out there who (somehow, exactly how they do it is beyond me…) genuinely recover with minimal to no treatment but from what I can tell from knowing a lot of ED sufferers what other people think is recovery without treatment is usually switching from AN to a less visible but equally internally destructive ED of some kind. It feels like recovery is a privilege for the rich and maybe some upper middle class in this country. Our healing should not be someone else’s profit.
To clarify, $5500 is a hypothetical based on 5 day a week treatment for a month, it could be less if you’re seeking less care (like 3 day a week IOP). That said, once I understood the process and upfront required for the balance billing, my jaw dropped a bit. I * get * it from a business perspective – they want to be guaranteed the money they need to operate (and profit). But this model doesn’t sit right with me given how inaccessible/exclusive it can make things for even people who are well off. From my understanding there are no payment plans on that lump sum either.
Does anyone who’s been through treatment at within have insight into how they worked with individuals who are not at a low body weight? My weight is normal right now, and I’ve never gone to treatment without needing to weight restore, but I’m also struggling so much mentally right now. I’m worried they wouldn’t take me seriously or I’d be treated differently maybe? Idk.
I’m currently at Within, and did not need to weight restore. I’ve only been treated with respect from all of the staff and other clients!
I’m at Within now – the program does not focus on restoration if you don’t need it. In fact, I haven’t had to restore, and I’ve had a great experience. You will be taken seriously. Depending on your level of care you can have anywhere from 1-3 sessions with your therapist a week, so even if the support you need is entirely mental and not focused on weight, you might be placed at a higher level of care. I’m open to answering any other questions you have 🙂
TYSM! Could you explain how food and meals work? Are you responsible for getting your own food and are you allowed to eat whatever you like as long as it fits into your meal plan from your dietician? And do you eat on your own or in a group? TY again!
Sure! For meals, they partner with Cook Unity and deliver 5-12 meals a week (depending on level of care). They will fit your lunch/dinner meal plan. You don’t have to have them, but they’re really convenient!
For all other meals, you will work with your dietician to figure out what works for you, and you are responsible for those meals. When you join, you do get a grocery delivery (they call them “welcome groceries”). Those are just basic things that will help if you don’t know what to have. They have a menu that you can decide to choose from, but if you want to have something else that is allowed as long as it fits your meal plan.
The way that meals work is that it is a group zoom call. You have one provider called a care partner (CP) who facilitates the meals. There are generally 4-8 other people in the meals with you. Everyone goes around and checks in, meaning saying what you are having and what you need during the meal. When you check in, the CP has your specific plan pulled up so they know what you need to have. This helps if you want to have something but don’t know how it fits in your meal plan. They will help you figure that out. After everyone checks in you have around a half hour to 45 minutes for the meal, and during that time you can have conversation, we sometimes play games, or you’re free to stay on mute as long as you have your camera on. Different CPs have different rules on what is allowed for phone use, but generally phones are not allowed during meals.
I hope this helps!
Super helpful, thank you! Do you get time to prepare meals/snacks right beforehand or do you do that on screen with the others?
Generally things are prepped beforehand. Depending on your meal plan you might be on “portioning support” which just means that when you sign on to the meal or snack you’ll have anything that needs to be portioned out (yogurt from a big container, chips/pretzels out of a bag, milk/juice to be poured, or fruit to be cut) ready to be portioned so that the care partner can see how much is being portioned. Like instead of coming with a peanut butter and jelly sandwich, you’d come with the bread and the container of peanut butter and the container of jelly and put it all together on camera, if that makes sense.
Do they use the exchange system for meals? I’ve been in ED treatment three times before and every program used the exchange system.
Ex: 1 cup 2% milk= 1 dairy, 1/4 cup shredded cheese= 1 dairy…..
Example Meal Plan for Bfast
1 protein, 1 starch, 1 dairy, 1 fruit, 2 fats
They use the plate method and the amount varies based on your meal plan.
Does anyone know if Within takes Florida Blue or Aetna (both PPO)?
I had Florida Aetna and it was not covered
Does within do trauma therapy? My teams looking for a higher level for trauma work with the support of ED treatment.
There isn’t necessarily a “trauma track” like some other places have. There are 2 specialized closed trauma groups that run on 12 week cycles. One of them is more structured and is focused on inner child healing. The other one is slightly less structured and is more of a process type group with some assignments along the way. Overall, Within is very trauma informed, but the facilitators of these groups are particularly wonderful.
Is within covered by Aetna PPO?
I’m looking for insight from anyone who’s been through treatment with Within. My insurance is now in network with Within which is great news, and realistically I know I need PHP. I’m not in a position to do that until May (financially it isn’t possible with my job and needing to keep a roof over my head), so I’m wondering if there would be any benefit to starting with IOP sooner to at least try to stabilize myself at my current level and keep me afloat until then, but I’m worried that if I do that and don’t make enough progress, my insurance will cut and I won’t even get the chance to step up to PHP in the summer.
Ideally I wouldn’t need to step up at all, but I’ve been on this cursed ED carousel for a long time and I have a good sense of where I’m at. I know only Within can answer this and I do plan to ask my admissions contact about it, but if anyone who’s been there has thoughts about the feasibility of this, I’d appreciate your thoughts!
I have been to within and I think it is a great program. I would say PHP is feasible with a job because they lowered (for most insurance providers) the minimum hours a day to 4 hrs for php and I believe still 3 for IOP so not much of a difference with hours. With PHP you get 2 meals and 1 snack in program and can use the “living room” feature for other meals. IOP is 1 meal and 1 snack and you can use the “living room” for any other meal support you need. I will say they do require in both IOP and PHP that you can fit in at least 3 appointments a week between 9am-5pm due to therapist and dietician schedules. There are groups running until 11pm EST most nights so you can definitely get in your group hours.
LMK if you have specific questions.
Thank you, this is really helpful! From your observations, do they seem flexible with letting people start out with slightly less support than may be needed due to circumstances, as long as medically stable? My assumption from previous reviews is that they’re pretty good at tailoring things to individual circumstances but I could be wrong on that. Also, what would you estimate the average length of stay at? If they only tend to keep people for 6-8 weeks at PHP level, it might make more sense for me to wait until I can commit to a full day so I can get the most out of it. Finally, have you noticed if they seem to allow people to keep the same team as they transition between levels of care?
Thanks again for any thoughts you can share. I’ve been through many previous treatment programs and am hopeful about one that does things differently, as I do better when I have more autonomy over things but still have the structure of a program and ideally quality groups.
It is so case dependent so you will really need to reach out to find out about LOC. I would say I have seen lots of people bounce around from PHP and IOP back to PHP etc. You do keep the same team between levels of care.
The average length of PHP varies so much. I was in PHP for months, and I know others because of insurance or because of readiness, were in php for 6 weeks.
In general since you are in your life and in program the length of stay is alot longer than average.
This program is very individualized and unique so hopefully you can work with admissions, the treatment team, and the care ops department to make it work for you!
A disclaimer for anyone like me – they do NOT know what they’re doing with DID. I was asked the following questions via email during the admissions process, after my initial assessment:
“They did have some follow up questions regarding your DID diagnosis:
When were you diagnosed with DID?
How many parts/alters are there, how often do the parts/alters present themselves?
Are there any alter/parts violent ?
Thanks!”
If that doesn’t give you enough to shiver at…anyways, they denied admitting me despite expressing that I have done a SIGNIFICANT amount of DID specific therapy work, I just really need extra support for the ED while I continued to work with my trauma therapist. “Stay far away” is the message I got from that very long denial process.
Do they take Virginia Medicaid
Within does not take medicaid and is OON with all insurances except BCBS of South Carolina. They work on OON benefits and single case agreements. They are working on getting in network with more insurances.
Some Kaiser plans now too (plus SCAs, like you said)
They take most major insurers, not sure where you got that info…
They will work on SCA’s with most insurance companies but they are not in network with most insurers. You can use out of network benefits with a lot of insurance plans with within but that requires balance billing and taking a risk that you will owe the difference between what insurance pays and the price of the program.
I used OON benefits and I was lucky to have it fully covered. But others might not have that same situation.
They work with people as much as they can to make things work but they are not in network 90% of the time.
I know this from current employees and from being a part of their community for a long time.
They didn’t take my Aetna.
What hours are groups and individual appointments available? I’m thinking of doing IOP after work and want to know how “flexible” their flexible scheduling is. I’m on the east coast, if that matters.
How accommodating are they to GI issues? I’m still getting testing so I don’t know the exact problems/needs yet.
Programming runs from 8am-10pm EST. So there is truly a ton of flexibility. You have to have some hours (usually 2-4 hours a week for IOP) between 9am-5pm to accommodate appointments with therapist, dietician etc who do not work nights.
I found them to be incredibly accommodating with GI issues but they still hold boundaries around making sure you meet your needs.
They are generally flexible. They did start a new system where you have to have the same hours each week, but you are generally allowed to pick the hours.
Has anyone had success continuing to work while doing IOP at Within?
Yes I did, they just require you have a few hours a week between 9am-5pm that you can have sessions.
Currently doing IOP five days a week while working. They really are a godsend when it comes to scheduling.
Does anyone know if they really have started contracting with some insurance plans? I can’t find confirmation anywhere on their social media / websites. It just says they accept insurance, but historically, that has been limited to OON benefits.
I believe they have! Not sure which ones though.
Only BCBS of South Carolina they are working on more.
Looking for any insight on within health. I have had a few residential stays and done php before and looking for something new. Has anyone had good success with this program? I have tried online php for a short time during covid and it wasn’t helpful due to not enough accountability, but this program seems to help more with meals and such. Just looking to see how it was for others. Thank you!
According to an email Within sent during ED Awareness Week, they are now IN NETWORK with BCBS of South Carolina (and it sounds like a few of the other BCBS plans on the east coast). Hopefully more follow soon!
Yes, I called Friday and they are in network with them! Of course I don’t have BCBS of SC. But yeah.
That’s very encouraging. I have Blue Shield of CA, but I live in NC so I’m always using out of state BCBS network participating providers. I could probably use that benefit if I were receiving services in SC, but not NC. It’s so confusing! I hope they contract w/ BCBS NC soon!
Has anyone tried using BCBS of SC? I have it and am considering Within.
They are in network, so it should be covered completely (minus whatever your copay is probably)
**TW**
Does within health do ng tubes? Or support them?
Nope
Oh okay!! I saw the ng tube tag, but I wasn’t sure. Thank you for clairifying
Oh thank you for pointing that out! I thought I had removed it, but haven’t yet. Yes I had been under the impression based on community feedback a couple years ago that they allowed NG tubes, but either I had misunderstood or they just no longer do.
Has anyone had any luck getting an SCA . And with which insurance
I did with Cigna. A few other insurances I know people had SCAs for when I was there: Kaiser, Caresource, Ambetter, Highmark, Cigna, lots of the Boston area plans, UHC… I’m sure there are more too.
But insurance is Blue Shield of CA and they said they do not typically create a SCA for a PPO plan. I asked if they do is there are no in-network providers within a commutable distance for PHP. They said no. They would just pay 50% after my $500 deductible until I met $3500 out of pocket max. Then, they would cover 100% of the agreement rate, but I would be responsible for all of the balance billing.
Has anyone been told this, too?
discouraged…
Yes 🙁 I have BCBS also and would have to pay my $6600 out of network deductible, plus 50% after, up to my out of pocket max of $17,000. They said an SCA wasn’t possible. Obviously a no-go for me.
And I think they can actually balance bill on top of the out-of-network rate, which means the OON max isn’t really a max. It’s just when the insurance covers a 100%of their OON rate. So if the company bills $200 a day more than the OON rate, for example, you always have to pay that extra $200 a day… Very discouraging.
I feel like I’m always a step behind the treatment options for one insurance reason or another.
I’m looking into MN’s Virtual IOP now. This whole treatment business can feel more overwhelming than it’s worth. Whenever I make a decision and bulldoze through all of the hurdles, the treatment itself has been excruciating for me to tolerate. My way isn’t working for me either, though.
Can someone share how the meals work with the delivery service? What are the options like? What about for breakfast and snacks? What if someone would prefer to cook their own food
Meal delivery is usually through a company called cook unity. There are selections based on your meal plan, dietary restrictions etc that you can discuss with your food specialist. For PHP I believe you can get 12 meals delivered per week and 6 in IOP. I didn’t use meal delivery because I preferred to cook my own food so I had them deliver groceries to me through instacart. For breakfast and snacks people buy their own food (unless you use the instacart service instead of meal delivery. There are sample menu’s for breakfast for both mealplans. In addition to the plate 30 or plate 50 you can have add ons. For snacks there are 3 levels and each has a snack list that you usually have to use when starting and then you can add more variety. Again snacks can have add ons. THe dieticians are usually very flexible.
What do you mean by plate 30 or plate 50? Does this refer to the plate by plate method?
Yes plate method
**TW**
I was told when researching for my daughter that Within Health did not necessarily accept low BMI and that a nasogastric tube was an automatic disqualifier. It says that they accept low BMI and ng tubes above. Does anyone know if they actually do accept ng tubes?
I have talked to many clinicians at Within and the founder herself about allowing NG tubes, and no they will not under any circumstances accept an NG tubes.
They will accept low BMI on a case by case basis.
I will fix the NG tag on our site, thank you love!
This is correct. They supposedly accept some low BMIs but many of us here on EDTR have had different experiences. From what I’ve gathered, if an individual is medically stable with a low BMI, they will trial them at within. If someone’s labs/vitals are not stable and BMI is low, within typically refers to a HLOC. Which makes sense, they can only do so much medical monitoring on a virtual basis.
They do not, under any circumstances, accept NG tubes. However, another program, Equip, which is also virtual, DOES accept NGs on a case by case basis. I have personally spoken to directors from equip and they said they will accept NGs if an individual is medically stable (and they DO have a strict minimum BMI).
From what I understand though, they are both very different programs. Within Health seems to be a much richer, busier more involved program with more community interaction where Equip is more of an individual arrangement with once a day-type interaction with providers. Am I correct?
I think this is true. I just learned this week that Equip actually offers 60+ groups, which I had NO idea. I’m talking to them currently so I’ll keep people posted on edtr!
But generally yes, Within I think is more involved. That’s part of why NGs are allowed at equip and not within, I think (bc an NG really messes with a community/mileu sometimes). I believe Equip is one of the only PHP levels that would allow a tube though
Yes. Within is PHP and IOP while Equip is outpatient. Equip takes the place of your outpatient therapist and dietitian over the long term, while Within is meant to be a short term intensive treatment. This is an example of a schedule at Equip: https://cdn.sanity.io/files/ibmh0om4/production/6eea7b321713c83dbc12c4b8ecc302259a9fb34b.pdf
And this is an example of a schedule at Within: https://withinhealth.com/university-student
I think bmi depends on where you’re coming from. If you’re going from HLOC and have a doctor to advocate for you I think they are more willing to accept low bmi
Agreed! I know I personally was coming from a HLOC and had 3 doctors, a therapist, and a dietitian, along with the HLOC, advocating for within, and they still denied. I know a few of us on edtr had that experience. But I know some have gotten in. I’m still working on convincing them to accept me though, because it seems like a really solid program
@anoncjl im sorry you had that experience! I feel fortunate that I was able to get accepted even with low bmi. I start on Thursday and I’ll post a review on this page while I’m in the program to help others decide if it’s right for them!
Did you end up doing Within Health’s PHP/IOP treatment? Would you be able to post a full review or even any information you have about it at all? Thanks!
I am looking into IOP at Within Health. They would need to obtain a SCA. Given it is a new year, I have a new deductible. Does the program require that this be paid to them up front or do they offer payment plans? I have very limited finances so would not be able to, in any way, pay such a large amount of money up front. Even a payment plan would need to be a small amount per month. Thank you for any thoughts or sharing your experience.
I think they often allow for payment plans. Worth calling and asking.
Anyone know if there’s a waitlist or how long the admissions process normally takes?
Waitlists are determined by state (based on the providers in your state’s case load) so I definitely would reach out to find out. Also, insurance can slow people’s admissions down but in general it’s a fast admissions process.
On average, the admissions rep told me it’s about two weeks from starting the process to admitting, but that there’s sometimes a waitlist which can affect things.
Does anyone know if they take Aetna insurance? Is it only out of network or out of pocket? Do you have to attend therapy groups and work with the whole team or could you simply just get group meal support?
You have to meet with the team and do at least some groups.
It is real PHP and IOP, meaning you have to do individual sessions, groups, and meals/snacks like you would have to do at in-person PHP or IOP. If you’re just looking for meal support, you might be better served working with a meal coach or a virtual meal support group as an outpatient. They definitely work with Aetna, but idk if it is out of network, in network, or through an SCA. Your best bet is to call them and ask them to run a VOB with your insurance before you do your intake assessment.
They did not accept my Aetna insurance and Aetna would not do an SCA. I hope you have better luck.
Aetna didn’t do single case agreement for me either. They don’t do them at all with Within. However they are sometimes covered “out of network telehealth” but I still have to pay a daily rate and coinsurance. Sharing this for others to see how this process might go!
Does anyone have the current group schedule?
Echoing this! I don’t need a schedule but I would love to hear what all groups are available
Non-inclusive list: CBT, DBT, ACT, process, anxiety management, working your nerves, how my body works, body image, body image and sexuality, family and relationships, relapse prevention, discharge planning, RO-DBT, ERP, affirmation and intention setting, RO + EO sharing (like a therapy homework check-in), breathe and stretch, flow yoga, pilates, strength training, emotion (like dance), BED process group, BED skills group, ARFID process group, recovery at every size, book club, core nutrition, portioning lab, liberation lab (like advocacy and values work), cooking group, baking group, weekend winddown, intuitive eating principles, self-compassion, shame and resilience, mom’s group / parent’s group, art therapy, experiential art, open kitchen, holiday food collages, Within University (college), Within Z (teens), professionals group (mental health / medical providers), BIPOC, LGBTQ+, chronic illness… there are even more I’m forgetting. They have like 60 groups at Within. They also divide a lot of groups by age—teen/young adult and “mature adults.”
Wow! I’m disappointed! Last year they were willing to push a SCA on my behalf. This year, they said I’d have to coordinate that myself. My benefits have not changed. ??♀️
The services they offer seem amazing.
which ones did you participate in and find to be beneficial?
I can speak from my experience my favorite groups were LGBTQ process (if that applies), Chronic illness Process, Mature Adult Process, Body image, Professionals group, psychodrama, general process.
I tend to prefer process groups obviously. I would say the portioning lab and cooking group, how my Body Works, core nutrition, RODBT, and book club were groups people who were newer to recovery benefited from.
What is chronic illness process and professionals group? Those two sound interesting to me!
Chronic Illness is a group for clients also living with Chronic Illnesses. I was not in it, but I assume it is run like a process group where people have the chance to share and discuss things they’re going through especially related to their illnesses. People seem to really like it!
Professionals group is another process group for medical and mental health professionals in treatment (like doctors, dietitians, therapists, nurses, speech therapists, and students in those fields). They also have a Professionals Alumni group for members after discharge so they don’t have to be worried about confidentiality running into a current or former client/patient in regular alumni group.
Yes to process groups! I also loved them and thought Within generally did a very good job facilitating. My favorites were Mature Adult process, General Process, Parents Group, Beyond Binging (now called AttunED), and ACT.
I also really liked Professionals Group!!! I wonder if I was in it with anon1 lol
My other favorite groups were art therapy/experiential art, RO-DBT, body image and sexuality, and ACT. They also have a lot of groups for family and friends that my partner and parents really benefitted from, especially the MLO/Male Loved Ones Group
What is RO and EO sharing? What is open kitchen? How many hours and days do people typically start at?
ROs and EOs are reflective and experiential opportunities. Like journal prompts (or art prompts if you prefer that) and challenges you are supposed to do. Your therapist and other team members will assign them to you or come up with them with you. In RO EO Sharing group you talk about the ROs and EOs you are working on that week and can share things you have written/done if you want. It’s like accountability and encouragement from the other clients. I liked it fine!!
Open kitchen is where the Food Specialists are in a Zoom room if you want to cook or bake anything with their support. It is usually right before dinner and is less structured than a normal cooking group. You can make whatever you want and they are just there in case you have questions or just want someone to talk to while you cook.
Everyone is different. If you are coming straight from the hospital or res (or if you should be in res), usually PHP 5 or 7 days a week is where you start. PHP is at least 5-6 hours per day. If you’ve already done PHP or are just stepping up and need less support, you might start at IOP. IOP is 3-5 days a week and usually 3-4 hours per day.
Does anyone know how they handle severe GI issues or chronic medical conditions? Do they have any virtual visits with GI or medical consults?
They will collaborate with your current PCP and any specialist doctors you see to make sure they work with your medical conditions while helping you meet your nourishment needs. If you see a GI doctor, for example, you can have them send that doctor weekly treatment updates and talk with your team as needed. You meet with your nurse 2-3 times a week in PHP, so they are able to keep an eye on a lot of medical stuff. They’ll also help you find a doctor, if needed.
They don’t have a GI doctor on their staff to do virtual visits (as far as I know), but each client has an assigned nurse and psychiatric provider. You have to have a PCP who is willing to order your labs and monitor you medically to do Within.
so is the eating meals and snacks on camera legitimately required or just an option? if it’s required, is it for every meal and snack or a select few? ty to whoever answers!
It’s required to be on camera. Depending on your level, you will also portion on camera. And no, you don’t have to do every single meal and snack in program, but you might if you need that support. For meals/snacks you have outside of program, you log them in the app.
They are now available in NC
Does anyone know if IOP starts 5 days a week or 3 days a week?
I started my first ever full-time job and my ED is escalating and depression surging quickly.
I don’t know if treatment would help me or not, but at this rate I don’t see myself succeeding at my new career without some intervention.
**TW**I’m the biggest I’ve been in 10 years, so that’s making it really hard to seek “help” as I used to require myself to be in a weight descent to justify help.**END TW**
thanks.
I just want to encourage you to try treatment! I don’t have any experience with Within unfortunately, but starting a new job is always stressful for me and if I hadn’t been doing treatment concurrently with the last time I started a new job, I would’ve completely spiraled. I didn’t fully recover, but treatment at least kept me afloat so I could stay in my daily life! Good luck and don’t give up <3
Thank you for the validation. I’m hanging onto the job by a thread. I have been writing letters of resignation in my head almost every day before I go into the office. It’s community mental health, salaried. I’m having to put in 50-60 hours a week to tread water. It’s been 3 mos. And I’m starting to think it’s not just my inefficiency. It’s an unrealistic work load.
*TW*
I will need consistent nutrient-dense nourishment to keep up, cognitively, emotionally, and physically – not just calories. I’ve got to pull it together!!!
I am currently at within and can answer some of your questions.
IOP is individualized in days but typically you would start at 4 or 5 days if you are appropriate for IOP. A lot of people in IOP work full time.
There is a huge variety of ED diagnosis, body size etc.
Do you have any other questions?
Do you have the group / class schedule in a format that could be emailed?
I’ve heard some of the experiential groups have had waiting lists, like yoga and art therapy. Was this an issue for you?
It looks like the meal service doesn’t offer much for breakfast options. Do they use a grocery delivery service for breakfast?
Do they have guidelines on how many hours a day your groups have to be meal versus process / psycho educational? Or if you want mostly meal support, can you request to split your group time that way?
Thank you!
The schedule is about to change on dec 18 but I can email it when I get the new schedule.
Yes, but the waitlist is only the Art therapy groups and they send supplies
They can send groceries for breakfast and you can do cook unity for other meals or you can just get all groceries.
Yes there are guidelines on how many hours you need and how many meals and snacks you can do.
no more than:
IOP 1 meal, 1 snack
PHP 2 meals, 2 snacks
BUT exceptions are made often
Currently at Within (IOP 4), did 5 months of PHP (7/6/5). Some other groups have waitlists- somatic foundations, embodiment, psychodrama. Others don’t have waitlists but require therapist approval (specialized – ARFID process, Recovery at Every Size, Beyond Binging, ED Professionals Group, Within University) or reaching a certain stage of programming (discharge planning, relapse prevention) or weight/health restoration (movement, strength training).
Do you have any idea how long people are usually waiting for access to those groups?
a few weeks at most, there isn’t always a wait
How can we exchange information to receive the schedule? My email is: makeyourquirkswork@gmail.com Thank you.
I do not have the current schedule:(
I don’t know how people can work full-time and have energy for IOP, even 3 days a week let alone 4-5! I guess I’m already seriously burnt out! I’m planning to give my notice tomorrow. If they have PRN, maybe I can go that, but I’m already at a crossroads.
When were you there? September 2022-August 2023
What levels of care did you do (e.g., inpatient, residential, PHP, IOP)? PHP for 8 months, IOP for 3 months
How many patients are there on average? There are around 100 patients in the program total, but you’ll never be in a meal or group with that many since they break it up into smaller groups. Usually meals are between 4-8 people and groups are maybe 20 max but usually get broken down into smaller discussion groups of 6-10 or so.
Does it treat both males and females? If so, is treatment separate or combined? Yes, combined.
If applicable: Do they support the gender identities of transgender and nonbinary people? Yes, to me they seemed very good about things like inclusive language and making sure to have people state their pronouns.
How often do you see a medical doctor, psychiatrist, psychologist (therapist), nutritionist, nurse, etc? In PHP: therapist 3x/week, psychiatrist 1x/week, nurse 3x/week, dietitian 1x/week. You also see your Care Partner (a dedicated milieu counselor who you check in with and who can help you complete therapeutic assignments called exposure opportunities and reflective opportunities) 1x/week and your food specialist (who orders your groceries and meal delivery and who can help with meal planning or cooking) 1x/week. In IOP: therapist 2x/week, dietitian 1x/week, nurse 2x/week, Care Partner 1x/week, food specialist as needed, psychiatrist as needed.
What sort of therapies are used (e.g., DBT, CBT, EMDR, ACT, exposure therapy, somatic experiencing, etc.)? DBT, CBT, ACT, somatic experiencing.
What were meals like? 1 hour total, including check-in and check-out. To start, you show the Care Partner leading the meal what you brought. This will either be your meal delivery or something you prepared yourself. If you’re preparing yourself, you’re supposed to portion on camera so the CP can make sure you have enough. They send you a phone stand in your welcome kit that should help you set things up so that both your face and your plate are visible to the CP during the meal. After portioning, you rate your hunger level on a scale of one to 10 and state your intention for the meal. At the end of the meal, you again rate your hunger and show the CP your plate.
What sorts of food were available or served? In PHP you can get both meal delivery and grocery delivery. They encourage you to use the meal delivery but you can also make your own food or do a combination of the two. For meal delivery they mostly use Cook Unity at the moment. When I started they were using Territory and Sunbasket so I don’t know how the Cook Unity is personally, but most people who commented on it said it was decent.
What is the policy of not complying with meals? If you didn’t complete your meal or snack, you stay after with the Care Partner who checks in on what’s going on and tries to problem solve. You can bring what you didn’t finish to the next meal or snack. They can’t do much beyond that but obviously if you continue not to complete they will eventually recommend a higher level of care.
Are you able to eat vegetarian? Vegan? Yes to both.
What privileges are allowed? Since this is a virtual program, you can kind of do your own thing so there’s not much they can do in terms of privileges. The only thing I can think of along those lines is obviously the movement recommendations – if you’re doing well and physically stable they will allow you to do Yoga and Movement groups.
Does it work on a level system? No.
What sort of groups do they have? TONS. CBT, DBT, ACT, Somatic Foundations, ERP, Body Image, Nutrition, Portioning Lab, Movement, Yoga, Meditation, Art Therapy, Wellness, Special Topics, Book Club (sounds more fun than it is – we just discuss the Intuitive Eating book), Weekend Wind Down, Anxiety Management, Cooking Group. That’s all I can think of right now but I’m forgetting a bunch. Programming goes literally all day and you pick and choose which groups you want to be in (unless you have a very tight schedule and just have to do things to get your 3 (IOP) or 6 (PHP) hours in). There’s also groups for specific people like Moms group, Professionals group (for clients who work in the ED field), LGBT, ARFID, and possibly others.
What was your favorite group? Movement and Art Therapy.
If applicable: Is the program trauma-informed? I can’t speak from personal experience here so I’m not sure.
What did you like the most? Two things: 1) This program is exceptionally flexible and individualized and will work with you to fit things in that are suited to your needs, whether that means only programming at certain hours because you have to work or take care of your kids or whether it means only doing certain groups because you have been in a lot of treatment and find the typical groups repetitive and unhelpful. 2) The people who work here all have experience working with EDs, even the lower-level staff like milieu counselors. Every other program I’ve been in hires people straight out of college without a clue.
What did you like the least? They don’t separate IOP and PHP at all, which I found a bit triggering towards the end of my stay. Also, the virtual aspect made it hard for me to really connect with anyone and could be frustrating since I live with roommates in a tiny apartment and it could be hard to make the setup for meals work with such limited space.
Would you recommend this program? If you are motivated and can make it work with insurance (you need a single case agreement), YES. If you struggle with “sneakier” behaviors like hiding food and table rituals and need somewhere stricter, this might not be the best fit for you.
What level of activity or exercise was allowed? In program, yoga and movement group. Outside of program, totally variable and up to your team.
What did people do on weekends? There is programming on the weekends but of course many people who are not in PHP7 take those days off.
Do you get to know your weight? I did not but I don’t know if that’s true for everyone.
If applicable: How fast is the weight gain process? For me it was quite slow.
What was the average length of stay? I have no clue. Most people do not stay as long as I did though.
What was the average age range? Huge variety – probably the most of any program I’ve been to. The accept clients starting at 13 and there were many older adults in their 40s, 50s, and 60s.
For PHP/IOP: What support do they provide outside of programming hours? On the Within app there is a “living room” feature where you can videochat with one of the Care Partners even if you have the day off or are done with programming for the day. There is also a “support” button that will put you in touch with a CP if you’re struggling.
What kind of aftercare do they provide? Do they help you set up an outpatient treatment team? I already had an outpatient team but I did need a new psychiatrist and they were helpful with that.
Feel free to ask any questions! There is a lot I could say about the program but this is already getting very long
Reviews for this program are very mixed but I want to share my experience.. it took months for within to finally accept me after initially saying I could do 4 days and it would be x amount of hours. Then once I was ready to start they changed saying it had to be 7days due to my medical stats. I was annoyed, I have a ft job but made it work for a little while. The admissions person I worked with told me (I have it all saved in email) that I could drop from the program any time with no ama or financial consequence. Later I found out this person was bullshitting me and my “treatment team” held an intervention and told me basically my insurance wouldn’t cover if I were to leave. Thankfully they did in the end and I wasn’t penalized but the trauma of having the team all go against me was awful. I think they were scared because I had proof that they flat out lied to me. There was NO communication between the psych/doctors or nurses and my actual, real life doctors whom I have trusted relationships with. Even they were confused as to why I was having to get labs drawn so often and thought within was not being realistic in their expectations of someone with a full time job and responsibilities. Nobody MADE me do the program and I felt that once I started, I was trapped and it was me and my doctor vs “the team” every step of the way. There were a few occasions I was told I needed to get lab work done asap and wasn’t given any reason why. It was a “drop everything now or else you’ll be non compliant.” I live 45 mins from my doctor and they wouldn’t count my time driving and going to appointments towards group, and I also have a full time job. It was exhausting and I wasn’t able to take any more off of work, which within didn’t support at all. They acted like life outside of the program didn’t matter at all and all they care about was covering their asses. They were so manipulative and degrading during my “intervention” and I left the program after a couple of months more defeated and frustrated than ever. The communication between providers is awful. They didn’t help find or set up any after care providers for me in the months that I was in the program. Groups were fine, some were repetitive but I got something out of most of them. I absolutely would not recommend this program especially to anyone with a low bmi seeking iop, they will absolutely not let you do anything less than 7days if you are are not medically stable, no matter how motivated you are for recovery. Also, the doctor was so caught up in my blood pressure readings (it was always high according to their equipment) and she suggested putting me on medication.. never in my life have I had high BP and I had it checked at work daily and at my doctors bi weekly, it was always normal. Despite that, within doctor wanted me on medication. HELL NO. No way was I taking medical advise based on a BP reading that I (NOT A MEDICAL PROFESSIONAL) am taking on MYSELF, probably not even using the device correctly. They didn’t bother to send me a new one, just assumed I had high BP. (I sure do now as I write this because I’m getting so worked up). Anyways, -4829/10 do not recommend.
I have had the oposite experience. My team talked to my dr and my outpatient therapist on a weekly basis. The admissions process was a bit rough and I don’t think the intake person was qualified to give me the level of care since mine was also differnt than originally stated.
For anyone doing the IOP, is it 3 hours straight? Or just three hours throughout the day?
also which groups do you do, like do you decide which ones you want to do?
It can be throughout the day if you want it to be. You can choose which groups you want to do.
I am in IOP at within currently feel free to ask any questions.
Hi! Are you still in their IOP? How are you liking it so far?
Hey, I think its a very good program. I have been to several res, IP, PHP, and IOP programs and Within has been one of the best. Virtual has its drawbacks of course. I am happy to answer questions.
Are the groups helpful or more generic? Do you feel there is more 1:1 support? Also, how do they go about the process of getting weights and vitals? Did you have an outpatient team, and do they work with that team? Thank you so much for responding I really appreciate it!
I’m not the same person who posted above, but I can answer some of this!!
Groups: The groups are helpful. They have CBT, DBT, ACT, all that of course, but also have groups for specific populations (ED professionals in treatment, college students, BIPOC, BED, ARFID, teens, probably others) and some more unusual groups like ERP and RO-DBT. They also have a lot of family programming groups.
1:1 Support: In PHP, you meet with your therapist 3x a week, RD 1x a week, nurse 2-3x a week, care partner 1x a week, psychiatrist 1x a week, food specialist 1x a week, continuity manager 1-2x a month, and clinical lead as needed. They also have the support button and living room where you can get 1:1 support. Partnership meetings with your whole team to review your treatment plan are once a month.
Weights and Vitals: They send you a numberless scale and a BP cuff. You set these up with your nurse and they teach you how to use them. You do orthostatics and weights on camera with your nurse during physio checks, but sometimes your nurse will have you do vitals independently too. I liked to do mine as soon as I woke up, for example.
Outpatient Team: I came in with a full outpatient team, but your continuity manager will find you referrals if you don’t have one.The Within team will call and speak to your outpatient providers when you admit and pretty regularly during treatment (as long as you sign a release of course), plus send them updates every week. They do a good job keeping outpatient providers involved if you would like them to be involved. My OP team even came to some of my partnerships.
Let me know if these answers are helpful and if you have any more questions.
They also created a separate meal group called “The Support Table” for people struggling and that provides smaller groups and more 1:1 support.
In PHP therapy is 3x a week, Dietican 1x a week, individual Care partner 1x a week, nurse 2-3x a week, psychiatrist 1x a week, and then any specialists you see 1x a week (movement, somatic, yoga etc). But everyones schedules might look a little different in terms of support.
You can make your schedule according to what works for you! It can be spread out throughout the day. Also something that I really appreciated about Within is that you can do up to 5 hours of programming per day while in IOP. By far the most I’ve ever gotten out of any IOP.
Hi has anyone done this program as an alternative to residential? Especially [with] a low bmi. I’m hoping I can be accepted because I’m not really able to leave home right now. I also have a lot of gi issues so it seems like they can handle that individually.
any recent comments on the meal delivery options too.
They will most definitely not take you, Mac. I’m so sorry to say. I have tried numerous times, and I can’t even get to the stage of sending labs for them to review. As soon as they hear about your BMI, the decision is made, then and there. ?
It’s so unfair, because Within’s program has pretty okay reviews, and so, SO many of us have a multitude of barriers to treatment. I always believe that at least some type of treatment is better than none, but nope, we are too much of a “liability” for them. ?
Riley, I’m sorry you had that experience too! I am actually at the stage where I’m just waiting for them to review my lab work, so they didn’t turn me down immediately. I was just curious since residential is my only other option at this point. Maybe different admissions counselors are quicker to turn people down.
Thank you, Mac! That could certainly be the case. Wishing you all the best as your move along this road. I pray for your full recovery 🙂 Keep is updated here how things turn out, if you are comfortable sharing. We are all rooting for you! ?
I’m gonna disagree with Riley here and encourage you to reach out anyway. There is of course a chance they might not take you as virtual treatment is not appropriate for everyone but I have been in the program for a while now and quite a few people here are doing it as an alternative to residential. Obviously I have no idea what their BMIs are so I can’t speak to that.
Agreed. Am about to admit and using it as alternative to Res.
I agree! Plenty of people use Within as an alternative to res – I did and it was very helpful. If someone is medically unstable to the point of needing IP level monitoring or at high risk for refeeding syndrome, they generally say no.
Do not waste your time. The person with whom I spoke when I called could not even remember my name. Say numbers below their supposed expert-guided requirements, and the talk is over. They do not care about your circumstances, history, rationale, nor desire for treatment. To make matters worse, the responses I received were rude and unprofessional.
I ended up being turned down because my labs were too unstable. They offered to reconsider if I stabilized. I really don’t know where I’m going next, very frustrating. My doctors aren’t offering me any guidance either but that’s another story.
Within is able to accommodate patients with behaviors that might typically mean they need to go to residential, but they can’t accommodate patients with medical instability indicative of a need for residential. At the end of the day, it is still a PHP and they can’t make it safe for someone who isn’t medically stable. I am really sorry you are having a hard time finding treatment. I hope you are able to get somewhere soon. I speak for all of us on this website when I say that we are cheering you on!!!
I agree with Anonymous’s comment, there are quite a wide range of body sizes in the program, and some people appear to have relatively low BMIs (although it is pretty much impossible to say how low or what the cut-off point is). Riley, I’m so sorry that was your experience. They can’t accommodate medical instability–I was referred to inpatient when my labs became too unstable, and they accepted me back once that was taken care of. They can handle GI issues, but they don’t have medical doctors, so you would be seeing your own outpatient doctor and having them communicate with your nurse.
As far as meal delivery, they’ve stopped giving grocery gift cards (can still have groceries delivered), and they now use Cook Unity for meal delivery services.
If they stopped giving grocery gift cards, are you getting even less value for what you are paying?
No, you get meal delivery (Cook Unity, Territory Foods, Sunbasket) or groceries delivered from Instacart. They also still do grocery cards for some people who don’t have delivery services in their area, but the meal delivery is part of the program when you are first admitted. People were never getting meal delivery AND grocery cards. It was always one or the other if that makes sense
Within can and does split between grocery delivery and CookUnity. I’m in PHP now and prefer to only do CU (12 meals/week) because it forces me to try a wider range of foods. I prefer to shop on my own for breakfast food and snacks. But I know others use both CU (6 meals) + grocery delivery, or only do groceries if they are more advanced / have special needs.
Yeah, I imagine there aren’t many breakfast options on CookUnity, especially plant-based.
I had the same experience. And in terms access, I agree with Riley but it’s not even just BMI – they are out of network and won’t do a single case agreement with my insurance. It’s definitely not cheap.
Can you say I would like to be in IOP for x hours a day x days a week, or do they not give you any choice as to the level of care you can get? Do you have to have meals delivered? How often are you weighed? Is there criteria for admission like bmi below x or anything?
They are very flexible with fitting programming into your life. I am not sure about LOC recommendations but it seems like they are willing to give people a shot. Also, hours for IOP are flexible from what I have observed.
you do not have to have meals delivered, I get a gift card to my local grocery store every week.
I am in php and do weights 3x a week. I am
not sure for iop how often weights are.
I have observed people of all sizes in the program. They won’t admit someone inappropriate for this level of care but they do seem more willing to work with people than any other program I have been to.
They initially led me to believe they would work with my schedule but once I admitted to the program they were not flexible at all. You don’t have to have meals delivered if you don’t want to, you can get groceries delivered instead if you prefer. I think the number of days you get weighed is based on your individual treatment plan.
The program can only be so flexible unfortunately because of insurance. If they’re paying for IOP then the program needs to document that you received at least 3 hours of programming. Same thing if they’re paying for PHP, the program needs to document at least 6 hours of programming. It can be hard some days but unfortunately insurance has an ungodly amount of control in how our treatment goes.
Everyone was talking about how helpful Within has been and so I reached out and did a consult.I was trying to seek care with Within and they told me that they would not do SCA with my insurance provider. They told me I could pursue their program with out of network benefits, but that they do balance billing and most clients are seeing charges of $450-$650 per day. I am sure if you have a program they do SCA on or they take your insurance, it could be a great program, but right now it is just so inaccessible for many of us.
I know that feels incredibly frustrating Anon! Please keep looking out for something to meet your needs.
That would be absolutely inaccessible for me as well, and for many of us! However, the numbers are helpful for having a ballpark figure for those who may be on the fence about pursuing it further.
Do you need support finding an alternative?
Hugs!
I’m so sorry! I’m admitting soon and found that, surprisingly, Within doesn’t generally work with PPO/POS insurance plans, as many HMOs are more likely to approve for a Single Case Agreement.
Apparently PPO/POS’s – like my previous plan (tried to admit last year) – prefer you to use your out of network benefits.
That’s so frustrating to hear because the only reason I switched from my HMO to PPO at work during open enrollment was because the HMO was so restrictive and would only cover the one crappy facility in my state, and I was hoping to have within as an option for HLOC! Thanks for sharing Anon.
I know and understand that you join meal support via camera, but are you required to have your camera on in group settings with other patients?
Yup! The expectation is that you always have your camera on, mostly for HIPPA reasons but also to make everyone in the group feel comfortable. Likely also for staff to make sure everyone’s safe.
Has anyone gotten an SCA from Oxford?
Also, is it worth it to begin with using out of network benefits, and switch over when the SCA is approved?
Same question, regarding starting w/out-of-network benefits and switching over to a SCA!
Does the Within program work on a macbook?
Yes, but if you don’t already have an iPhone they will send you one to use for program. You just have to return it when you discharge.
Thank you. Is a phone screen too small to have that immersive experience, though?
Also, are there any other applications that are required for the program, or everything’s embedded in Within Health’s app?
They do a lot of group stuff on Zoom, so it’s not so small. Individual work generally on the phone screen. I got used to it pretty quickly.
Meals, snacks, groups, and some individual sessions take place over Zoom. There is an in-app video interface but it’s not great. A lot of people just use their phones. They’ll send you a phone stand in your welcome package. My personal preference is to use my laptop whenever I can—I just email myself Zoom links that are given in the app.
I’d definitely say the small screen absolutely makes it somewhat difficult. You can download the app onto an iPad which is what I did and found it much more immersive that way. Sometimes groups or meals move to zoom and in that case it’s definitely easier to log on on the computer
Most of my questions are about the food protocol, except the first one.
Do you know if the scales they use provide them w/ any metabolic or body composition data (BIA)?
I’m wondering if anyone who has been here can list the options you were given for meal delivery.
What subscription services did they offer you?
If you asked about a particular subscription service, were they open to considering adding it to their options?
What service did you use?
Did they send snacks via grocery delivery?
Did they allow or encourage a transition from pre-made meals to prepping your own via grocery delivery?
If you had grocery delivery, did you have enough time in your PHP schedule to actually prepare a meal during the day or did you have to prep in advance?
Thank you!
Do you know if the scales they use provide them w/ any metabolic or body composition data (BIA)?
I’m wondering if anyone who has been here can list the options you were given for meal delivery. What subscription services did they offer you?
If you asked about a particular subscription service, were they open to considering adding it to their options?
What service did you use?
Did they send snacks via grocery delivery?
Did they allow or encourage a transition from pre-made meals to prepping your own via grocery delivery?
If you had grocery delivery, did you have enough time in your PHP schedule to actually prepare a meal during the day or did you have to prep in advance?
Thank you so much!
Hi all—I know there has been a ton of interest in Within’s virtual programming and I originally reached out to them a few months ago. Unfortunately, they wouldn’t accept Medicaid, and I was unable to move forward. Now that I have Cigna, it opens me up to accessing many more options, including Within.
However, they are now giving me the same runaround about out of network benefits, and out of pocket expenses as many of you have also noted. I just don’t understand how they can say “we don’t know what you’ll be responsible for paying until weeks after treatment.” How are we supposed to just willie-nillie join the program? Do we do that, and hope we won’t get hit with an exorbitant bill?! Who can do that? They basically said in their email explaining my benefits vs the cost of their care, “maybe we’ll pay, maybe you’ll pay, we dunno the deets, sorry!”
Has anyone done the program and been hit with a crazy final bill? Or a crazy bill during treatment? If so, did you dispute it? And if so, did you “win?”
It’s all so confusing, and it’s a shame because it seems like such an awesome program, and it feels like they’re really interested in helping people who can’t access, or commit to long, consecutive hours of programming, and it also feels like they can tailor it to fit individual needs.
Any insight?
Hi Riley!
I’m currently trying to get an SCA for Within.
Initially, the first person I spoke with in admissions ran my benefits, which were out-of-network (they are not contracted in-network with any insurance companies afaik) and it was, like you said, unclear and hard to navigate. They basically told me sorry and good luck.
A couple weeks later, I called them again, got a different person in admissions, and asked what I needed to do to apply for a single case agreement (SCA). As it turns out, they actually take care of that for you (I don’t know why the first person I talked to didn’t tell me this). I had an assessment and got medical clearance to ensure that it was an appropriate level of care for me, and they submitted all of that information and more to my insurance company for the SCA application.
I’m under the impression that if the SCA is approved, it will be clear how much I will end up having to pay out of pocket. I absolutely would not start treatment until all of that is fully authorized and explained clearly.
Unfortunately, it’s looking like my insurance company is fighting it. If they don’t approve the SCA with staff from Within, it will then be in my hands to advocate for it on my own. I’ve been told many patients have successfully fought for an SCA after initially being denied.
It’s a long and arduous process, but I think it can be made easier if you manage to get in contact with the right people in admissions.
It really does seem like an excellent program, so I’m willing to put in the effort. But god, it IS frustrating, and I feel your pain.
Sorry this reply is impossibly long. You have my email if you would like more specifics.
Thank you for this response! It is very helpful, (for all of us!)
I agree the program seems like a very good option for many people, which is why, like you, I may push forward, and try for a more “concrete” SCA.
It’s so frustrating they don’t tell us that SCA’s are a way in, but I guess they figure if we are that in need, we’ll just pay and ask questions later? (I’m just guessing.)
So great to see you advocating for your needs—it’s amazing so many people are trying so hard to get help!
Hey, just wanted to follow up here. I got my SCA approved and started treatment today. Within sent me a financial agreement document that very clearly stated my personal financial responsibility, which worked out to be my in-network out-of-pocket maximum. It had to be paid today, the day of admission. I’ll follow up again if I end up getting any surprise bills, but it really doesn’t seem like I will.
I hope this encourages others to keep trying to get an SCA and inspires hope that this program might truly be financially feasible despite the hurdles you may have to jump through. Wishing everyone the very best of luck!
This is great news C, thank you for updating us and congratulations! Did you end up having to advocate for the SCA with your insurance co or did they approve it after Within pursued it for you?
Thank you! I didn’t have to, they were able to get the SCA negotiating on my behalf. I was honestly shocked. I thought it was going to be a lot harder and I’m beyond grateful that it went as well as it did. Cried happy tears when I got that email!
This is seriously so encouraging, not just for us, but for countless others without access to immediate care. It is such a great option for numerous reasons, and for me, it could be the perfect step-down program that will allow me to return home after I complete IP and possibly Res.
So happy for you, C! Please keep us posted as you move through the program, and yes, if you receive any funky bills.
It’s very good to know that they won’t even let you start the program without fully understanding your financial obligations. 🙂
Is Within experienced with treating ARFID? I don’t see anything about ARFID on the site. Also, did anyone here with BCBS, Health Net or Molina get treatment covered by insurance? If so, would you mind sharing what plan you have that covered it? I’m trying to get a new insurance plan now and it needs to cover treatment! Thank you! 🙂
Following up – please lmk if anyone has managed to get an SCA through BCBS (PPO). I was in treatment for six months last year and am now back to where I was when I began 🙁
I’m not willing or able to go IP/Res again for a variety of reasons – I cannot spend that much time away from my child again, nor can I lose my job – and Within looks like the only feasible option rn.
Not sure about the SCA, but yes, Within has an ARFID track. You can do food exposures with your RD and food specialist, sometimes have shorter but more frequent RD sessions to do exposures, as well as have access to an ARFID-specific process group and an ARFID-specific meal/snack section.
I have BCBS Community Blue PPO and I got an SCA. That’s not a guarantee at all that you can get one too, though–my case was approved mostly on the basis that I live in a very rural area. Still worth trying! Best of luck!
Did you have to initiate the SCA w/ your insurer or did Within start the process? Last year they said the y would initiate; now it’s up to me.
Admissions is a bit messy. They initiated the SCA for me, but only after a few months of confusion. Keep pushing, it’s an incredible program that got me to full recovery. Highly recommend despite the admissions issues.
SO many of us here have had this exact experience. Keep pushing, everyone! Advocate!
How do they decide which groups you participate in each day? Are you given a list and choose or do they assign them to you? Also do the hours per day have to be consecutive? So for instance if I start at 8 and need six hours, I have to attend until 2 or can they be broken apart with some in the morning and some later in the day?
Hours can be broken apart. They will put you into groups based on your availability but if there are certain groups you would like to be in or your team thinks you should be in, it’s easy to let them know and they will put you into those.
Hello, wondering if anyone can weigh in about how much they paid after care for their balance billing rate? We have BCBS and are very concerned about entering and not being able to afford staying.
It really depends on your specific insurance plan, so what one person pays in balance billing could be super different from what another pays. Within has the rate they charge your insurance per day, but if your insurer won’t agree on a rate with them in advance then there isn’t a ton that can be done (at least that’s how I understand it). Perhaps you could ask your case manager at your insurance company how much they typically pay for an out of network PHP/IOP and bring that number back to Within? Another option would be to find out if your insurance will pursue a single case agreement with Within. Crossing my fingers for you to get the treatment you need!!
Do they accept blue cross blue shield. Their site said they do. Their site said they have licensure with Texas. But that I don’t have coverage either way which I know is not true
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They do accept BCBS, but some BCBS plans don’t allow for single case agreements or out of network coverage. I bet that’s what’s going on here. It really just depends on your specific plan and what’s allowed. If you haven’t already, I would ask your insurance company for a case manager to help you access treatment and tell them you are interested in Within to see if they can help at all. Good luck!
Am I able to see my outpatient trauma therapist at the same time for trauma as i told them i had 2 years of ed treatment and have all the skills but trauma holds me back just wondering. Also i work at starbucks and it would really be hard to follow that schedule for work in the mornings since I wake up at 3 and go to bed around 6 pm
Yes! I know of others who’ve done this. I think sometimes insurance will refuse to cover outpatient sessions while covering a higher level of care, but those who I know who have done this pay their op team out of pocket.
Does Within pursue SCAs with Medicare or not work with Medicare at all?
Within does not work with Medicare. More like, Medicare does not work with Within. Medicare only covers PHP/IOP programs when they are either located in a hospital or part of hospital system. For example, PHPs that take Medicare can be found at Sharp Mesa Vista, Sheppard Pratt, Melrose @ Park Nicollet Health, Rogers Behavioral Health, Alexian @Ascension, Linden Oaks @ Edwards-Elmhurst, Klarman @ McLean, Tower (formerly Brandywine), Sanford, Reasons @ BHC Alhambra, UPMC, Reflections @ Dominion, Johns Hopkins, etc)