Insurance Claim Denials for Mental Health Treatment

Based on the circumstances, virtually any health issue can be denied for coverage by insurance providers. Typically, if they are denied, it is after a thorough investigation of the insurance company that ends with them concluding the treatment was unnecessary. The problem that patients who are suffering strictly from mental health disorders are now facing is that their insurance providers are not conducting a proper inquiry before denying them.

Why are mental health care treatment insurance claims being denied?

The Affordable Care Act was meant to bring health care to more people across the country, including those who were suffering some sort of mental health disorder. Nothing seems to have changed, however, and patients dealing with common mental disorders – such as depression or anxiety – are still being denied insurance coverage for treatment at a rate noticeably higher than people suffering from other maladies. So what is going on?

The problem might lie in the fact that there is no easily identifiable symptom or procedure involved with treating psychological issues. Insurance companies are quick to look to injuries or surgeries and determine if they are critical or not. When a patient requires a prescription pill to adjust their mood, though, there is no definite way to know if it will ever help them, so insurance companies tend to keep out and cut their expenditures. In this case, they are operating under the belief that if a treatment might not succeed, it is not necessary.

This problem of insurance denial is not something that affects just those who are acting on a whim, either. Even patients who have been carefully prescribed some sort of medication or treatment by their physician are not getting the financial benefits they need.

What can be done about this ongoing issue?

Until scientific advancements allow physicians to provide some sort of quantifiable measurement of mental illness, insurance companies are likely to be hard-pressed to give money towards treatments. In the meantime, an insurance claim denial can always be appealed with the help of a legal professional.

If you believe you are being unfairly denied medical coverage for a mental health issue and that your insurance provider might be acting out of bad faith, Mansell & Mansell, APC can help. Our Los Angeles bad faith attorneys have more than 90 years of collective experience with fighting insurance companies and defending the rights of our clients. You should be as comfortable and healthy as can be, and with our support, we can help get you there.

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