Obtaining Treatment Authorization in the Complex World of Insurance

Until our national policy catches up with our mental health realities, navigating our healthcare system can be a difficult maze. But when your loved one's life is on the line, it doesn't matter how the system got to be such a mess, you just want to get them help as fast and effectively as possible. Most insurance policies have a designated appeal process, however that process can take a long time. Rather than face that long and arduous undertaking, the ideal scenario would be to get a "yes" on the first request for treatment authorization. Throughout the process, a person should know all of the rights and coverage afforded to them under their policy, understand which mental health parity laws can be leveraged to their advantage and know how to put together complete documentation. All participants will walk away with an outline of the process from the first call to submission of the authorization request, and sample documents such as a medical necessity letter for co-occurring illness. The session will also include a brief discussion of options for people with Medicaid and for those without private insurance.