The Mental and Nervous Disorder Utilization and Cost Survey in Washington, D.C., has yielded useful information about outpatient utilization within an insurance plan with broad mental health coverage, as well as evidence that a comprehensive benefit with a low deductible and copayment can be offered and reasonably utilized. From the results of this survey and a substudy of claims made during 1977, the authors conclude that psychiatric diagnostic information submitted on insurance claim forms may often be inaccurate, primarily because of providers' concerns about confidentiality; such information is of little use for peer review or claims review. The authors state that caution must be exercised in generalizing from the experience under this plan to speculate about outpatient utilization which might result from broad coverage on a national level.
ASJC Scopus subject areas
- Psychiatry and Mental health