How to Help Patients Get a Mental-Health Insurance Reimbursement
Patients often struggle obtaining mental-health insurance reimbursement. The reality is that a patient's mental-health issues are aggravated when he worries about whether the cost associated with vital treatment will be approved by an insurance carrier. Understanding how to get an individual mental-health insurance reimbursement is an important element in providing services to a patient.Things You'll Need
- Claim form
Instructions
Contact by phone or email a health insurance company's claims department immediately upon a patient's admission to a mental health treatment program--outpatient or inpatient.
Advise the claims department about the specific course of treatment prescribed for the patient.
Explain that the course of treatment not only is preferred but is required to address a serious mental-health condition. Underscore that there is no other reasonable course of treatment available that is effective and as cost-efficient.
Obtain a claim form from the health insurance company. The insurance carrier can fax or email this form to you immediately.
Complete the claim form, obtaining any necessary supplemental information from the patient if possible.
Include as much medical documentation available to support the claim form.
Have the clinical director sign the claim form--noting her title--if she is available. In some instances, the fact that a clinical director signed off on a claim form assists in obtaining a positive response to the claim.
Submit the claim form to the insurance carrier claims department.
Prepare to respond to an initial denial of a claim made on behalf of a patient for mental-health insurance reimbursement. Some insurance carriers deny an initial mental-health claim as a matter of routine. Therefore, at the outset, familiarize yourself with the claims appeals process at a particular insurance company.