My friend was diagnosed with mental problem and his health insurance claim was denied. At first, I thought everything was okay already but when I saw the medical bill, I felt sick too. lol. Actually, this happened long time before and I do not want to happen it again. Do you know any Denial Defender software that can avoid health plan rejection and denial? How can I know that the insurance covers both physical and mental issues? I just need your reply ASAP. TY
Does Your Insurance Cover Mental Health Services?
- Thread starter spudscoffee
- Start date
I was advised by one of his doctors to use this "Denial Management Software". Anyway, I am gonna read and understand the details in the link to check if this software fits the needs of my friend. TIA
Tin Man
"a respectable amount of screaming"
My insurance covers everything, 100%.
But only after a certain point, and up to that point, I pay for everything out of pocket.
So it is like it covers nothing at all.
Might be good in a catastrophe.
But only after a certain point, and up to that point, I pay for everything out of pocket.
So it is like it covers nothing at all.
Might be good in a catastrophe.
lol, I guess that my car insurance cares about health of its customers more than health insurance companies... Seriously, once my friend from work had heart attack, and got into an accident, there was nothing grave, but he needed an ambulance, and you know, our courier insurance about which you can read more at this site www.total-insurance.co.uk (I've forgotten to mention that we're couriers) paid him compensations because of the accident and money for his recovery... Lol, even health insurance wouldn't care so much about people...
I've never heard of such software. Call your insurance company to be sure they cover mental health care. (Pet peeve of mine: The insurance companies love to hide these benefits from us but when someone needs to see someone the info about them needs to be just as accessible as the ER info.)
Is your friend is on one of the many US healthcare companies? These I know more as I've worked with one of the major carriers years back.
Usually a visit, or set of visits in the case of mental healthcare, to a specialist (anyone outside of your Primary Care Provider) require a referral prior to the visit, otherwise the claim will be rejected.
I get super sick and upset when I see those bills too. Insurance companies are super hard to deal with too.
Here is what I do if/when I receive a bill from a specialist:
1) Make sure the specialist is in network for my health insurance and that I did not need a referral.
2) Call the doctor's office issuing the bill, make sure they billed the right code to the insurance company (sometimes rejection could be one digit off and they just need to resubmit.)
3) If I needed a referral - Call my PCP and tell them the situation - ask for a referral to the doctor.
4) Write a letter of explanation to the insurance company, include notes from both the PCP and specialist regarding the urgent nature of the visit, note the referral that you now have in hand and ask for reconsideration (they make the rules and they can bend their own rules if need be).
5) Upon rejection of the above - repeat the above with new wording.
I'd help you if I could. I've had to do the above for ER visits for myself when I could not call before heading in. Eventually the insurance company figures it's just not worth their time to fight it and pays the bill.
Is your friend is on one of the many US healthcare companies? These I know more as I've worked with one of the major carriers years back.
Usually a visit, or set of visits in the case of mental healthcare, to a specialist (anyone outside of your Primary Care Provider) require a referral prior to the visit, otherwise the claim will be rejected.
I get super sick and upset when I see those bills too. Insurance companies are super hard to deal with too.
Here is what I do if/when I receive a bill from a specialist:
1) Make sure the specialist is in network for my health insurance and that I did not need a referral.
2) Call the doctor's office issuing the bill, make sure they billed the right code to the insurance company (sometimes rejection could be one digit off and they just need to resubmit.)
3) If I needed a referral - Call my PCP and tell them the situation - ask for a referral to the doctor.
4) Write a letter of explanation to the insurance company, include notes from both the PCP and specialist regarding the urgent nature of the visit, note the referral that you now have in hand and ask for reconsideration (they make the rules and they can bend their own rules if need be).
5) Upon rejection of the above - repeat the above with new wording.
I'd help you if I could. I've had to do the above for ER visits for myself when I could not call before heading in. Eventually the insurance company figures it's just not worth their time to fight it and pays the bill.
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