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Mental Health

According to the National Alliance on Mental Illness, mental health benefits claims are two times more likely to be denied than general medical care claims. Historically, there has been a disparity between mental health benefits and other medical benefits that makes it more difficult to obtain coverage for behavioral health care and services. While there are laws on the books to address this issue, barriers to affordable mental health care are prevalent. 

At Green Health Law, we are committed to fighting for the rights of patients and plan participants. Through our comprehensive mental health insurance legal counsel, we have helped countless individuals obtain the coverage they need and deserve. Standing up to insurance giants and their legal teams can feel intimidating, but we do not shy away from the challenge. To learn more about how we can help, consider contacting our office today.

What Are Mental Health Parity Laws?

We believe that all people should have access to health care benefits, including necessary behavioral health services. For years, health insurance plans have imposed barriers that limit the access to crucial behavioral health care services. The ubiquitous practice of offering unequal coverage for mental and behavioral health services puts many Americans at risk of incurring substantial financial losses due to out-of-pocket medical costs. 


The federal government took an important step toward addressing these disparities by enacting the Mental Health Parity and Addiction Equity Act, which established the principle that there should be no discrepancy in health insurance between mental health and general health benefits. Mental health parity laws prevent insurers from imposing unfavorable benefit limitations on mental health services, thereby protecting your right to accessible and affordable behavioral health care.

Our Comprehensive Mental Health Benefits Services

At Green Health Law, we are proud to offer unparalleled comprehensive legal representation for clients seeking mental health benefits across the nation. We have more than two decades of experience navigating issues related to health law and medical insurance and have developed a unique focus on mental health benefits. Our breadth of knowledge and unparalleled expertise in this area allows us to support our clients and guide them through even the most complex legal issues. 

We have represented patients and plan participants in a diverse range of mental health conditions requiring mental health benefits and insurance coverage. Some of the mental health benefit issues we have successfully resolved for our clients include the following: 

  • Inpatient hospitalization
  • Residential treatment
  • Partial Hospitalization treatment
  • Intensive outpatient treatment 
  • Nutritional counseling for eating disorder patients
  • Mental health conditions including eating disorders, bipolar disorder, schizophrenia, major depressive disorder, generalized anxiety disorder, substance abuse, and other mental health diagnoses
  • Treatment of patients of all genders 
  • Treatment of patients as young as 10 years old 

 

Our work focuses on protecting the interests of patients and plan participants and ensuring that our clients receive the coverage they need and deserve. Relying on our experience, resources, and knowledge of state and federal legislation and case law, we have been able to successfully resolve disputes for countless individuals and families.

What Should You Do If Your Mental Health Benefits Claim Is Denied?

If you have been denied mental health benefits, it is important to act quickly and take steps to protect your rights. By taking action, it is possible to hold the claims administrator and health plan accountable for wrongfully denying your benefits claim. After your mental health claim is denied, it can be helpful to take the following steps: 

  • Keep detailed records of your claim. Successfully fighting an unfair denial depends on the evidence you have to support your claim. Ensure that you keep records of your claim, including documenting telephone calls, explanations of benefits, denial letters, appeal letters, date(s) of service, and the reason for your denial. 
  • Review your summary of benefits and coverage. Your health plan will include information regarding what services are covered, deductibles, and copays that you will be required to pay. Review your summary of benefits and coverage to ensure that you have adhered to the rules of your specific plan. Importantly for mental health claims, your health plan will provide specific requirements for coverage and the claims and appeal process for mental health treatment.
  • Speak with an attorney with knowledge regarding mental health benefits. It is possible to appeal your denied claim, but doing so requires time, effort, evidence, and knowledge of your rights. The health insurance companies and health plans are abundant with resources, and they profit by denying claims, establishing an incentive to withhold or deny benefits. Appealing the denial is often the difference between obtaining coverage and paying out-of-pocket for your medical care. Working with an attorney with knowledge about mental health benefits can help improve your chances of success greatly of having the claim approved, saving you time and money. 

 

Between paying your premiums and navigating the mental healthcare system, it can be incredibly frustrating when health plans do not fulfill their obligations to provide coverage for your necessary mental health services. If your mental health benefits claim was denied, we are prepared to fight for your rights. 

How Can an Experienced Attorney at Green Health Law Help?

At the core of our practice is a passion for patients and plan participants’ rights. We work tirelessly to uphold mental health parity laws and hold health plans accountable for unfairly denying mental health claims. We use a range of legal strategies to protect our clients’ interests, including: 

  • Understand the health plan’s coverage. Knowing what is covered under your health plan is the first step to advocating for coverage. We can review health plans to determine what the health plan is legally obligated to provide for benefits, timing of the appeal process, and other legal issues affecting your mental health benefits.
  • Reviewing parity laws for violations. This is a common approach we use in mental health cases. If there is any evidence that your insurance provider handles mental health claims differently than other benefits claims, we can use this to our advantage and hold them accountable under parity laws. 
  • Proving that your care was medically necessary. Claims administrators may claim that your care was not “medically necessary” and therefore should not be covered. Using evidence such as treatment records, letters of support from therapists, psychiatrists, and treatment team, we can prove that your care was necessary for your recover and to improve your overall quality of life. 

 

Speak With Our Team Today

Navigating a denial of a mental health claim can feel overwhelming and incredibly frustrating. Fighting the claims administrator and health plan to have the claim paid can add to your stress and impact your healing process. At Green Health Law, our team has handled a range of mental health issues and developed a robust understanding of the unique rules and regulations surrounding this area of the law. We have successfully appealed and litigated countless cases, ensuring that our clients obtain the benefits they deserve as quickly and efficiently as possible. To get started on your case, consider speaking with an experienced attorney.