ADHD - Appeal to Lower Treatment Costs
Are you one of the many people who have health insurance but find it difficult to convince your insurance company to cover the expensive medical costs of ADHD? Unfortunately, part of the managed care effort mandating that costs should be kept low require claims to be denied, even if they are legitimate.
If every claim made was covered by insurance companies, costs would be double or more what they are now.
Regrettably, this means many of your ADHD-related claims will be denied by your insurance company.
However, there are independent review boards in 42 of the 50 states whose decisions can supersede what the insurance companies say.
While most people give up when their insurance provider denies their initial mental health benefits for ADHD, there is an appeals process that you can access.
Of course, this can be a lengthy and frustrating process, one which some people do not have time or patience for, no matter how valid their claim is.
However, when a large enough amount of money is at stake, it can truly pay off to appeal your claim.
Plus, over half of patients win their first in-house appeal, so the odds are in your favor.
You can appeal more than once, and studies show that of those who appeal a second and third time, about 44% of patients win their appeal in both situations.
For the highest probability of wining your claim, either the first time or through one or more appeals, there are few things you can do.
First, read through your current policy closely.
If mental health benefits are included, particularly for a "non-serious" condition like ADHD, you have a better chance of having your claim approved.
Then, always have proper written documentation to prove the severity of your child's ADHD.
Many insurance companies can deny your claim for ADHD medical costs because it is not serious enough.
However, the condition can be diagnosed at different levels of severity, and you can prove what your child has with the proper documents.
Especially if you are undergoing an appeal, keep good records of who you talked to, how you reached them (phone numbers), when you contacted them, and what was spoken about.
This kind of record keeping is often beneficial when dealing with a bureaucracy.
Lastly, start the process of appealing early.
If your doctor indicates that he wants to see your child weekly for their ADHD, begin to appeal your 15-visit-per-year policy as soon as you can.
If you need assistance in locating particular coverages at a pre-determined price, we can help you save up to 50% on your health insurance monthly premium.
If every claim made was covered by insurance companies, costs would be double or more what they are now.
Regrettably, this means many of your ADHD-related claims will be denied by your insurance company.
However, there are independent review boards in 42 of the 50 states whose decisions can supersede what the insurance companies say.
While most people give up when their insurance provider denies their initial mental health benefits for ADHD, there is an appeals process that you can access.
Of course, this can be a lengthy and frustrating process, one which some people do not have time or patience for, no matter how valid their claim is.
However, when a large enough amount of money is at stake, it can truly pay off to appeal your claim.
Plus, over half of patients win their first in-house appeal, so the odds are in your favor.
You can appeal more than once, and studies show that of those who appeal a second and third time, about 44% of patients win their appeal in both situations.
For the highest probability of wining your claim, either the first time or through one or more appeals, there are few things you can do.
First, read through your current policy closely.
If mental health benefits are included, particularly for a "non-serious" condition like ADHD, you have a better chance of having your claim approved.
Then, always have proper written documentation to prove the severity of your child's ADHD.
Many insurance companies can deny your claim for ADHD medical costs because it is not serious enough.
However, the condition can be diagnosed at different levels of severity, and you can prove what your child has with the proper documents.
Especially if you are undergoing an appeal, keep good records of who you talked to, how you reached them (phone numbers), when you contacted them, and what was spoken about.
This kind of record keeping is often beneficial when dealing with a bureaucracy.
Lastly, start the process of appealing early.
If your doctor indicates that he wants to see your child weekly for their ADHD, begin to appeal your 15-visit-per-year policy as soon as you can.
If you need assistance in locating particular coverages at a pre-determined price, we can help you save up to 50% on your health insurance monthly premium.
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