I don’t know why I expect differently. I always end up being disappointed, frustrated, angry, depressed. Yet, our systems’ mental health support and lack of resources, for some reason, never cease to amaze me!
As you may recall, Jeff and I are going through the process of appealing our health insurance denials of claims for Chloe’s treatment in Utah. We hired a third party administrator that specializes in helping families with this process and have paid nearly $13,000-to-date.
Why, you might wonder, does it cost so much just to file appeals? First, the process is cumbersome, confusing and takes months to navigate. And, if you’re not an attorney, good luck understanding the nuances of your health insurance policy and how to go about fighting denials.
Second, much to my chagrin, insurance companies require up to three appeal attempts (retroactive review, level one and level two appeals) before even allowing their subscribers to submit it for an external review by the state or take the case to litigation. So, yes, there are a lot of hoops, it’s time consuming, and you basically feel demoralized after each denial.
To add more salt to the wound, when you’re finally ready to take your case to an “independent” external review administered by your state or to litigation, the chances of recovering monies for a case like Chloe’s are minimal.
As I’ve pointed out before – why is it such a surprise that mentally ill kids and people continue to flounder? The resources are just not available. It starts at the very basic level of appropriate, expert support at the schools, to educating and providing resources to family members, to health insurers covering critical services, to our community leaders enabling funding to address and mitigate problems.
I recently published ON THE EDGE, a book about parenting mentally ill children and the realities of our inadequate mental health system. I have a few important reasons for writing the book. First, to share other families’ stories and let people know they’re not alone. I also want to use it as a platform to spread the message with the media, action groups and legislators about how mental health resources and support are failing our country, communities and families.
It’s time for reform. ON THE EDGE is available on Amazon.com – https://www.amazon.com/dp/1733591907 .