I’ve been denied medical coverage. How can I file a complaint?
You may also wish to investigate whether your rejected medical claim is a result of a disparity in medical coverage. The following resources may be of assistance.
Against an Insurance company
Psych Appeal is the first private law firm in the United States that specializes exclusively in mental health insurance advocacy on behalf of patients and providers (fee-for-service). Psych-Appeal affiliates with the country’s leading law firms as well as with the Parity Implementation Coalition, the Saks Institute for Mental Health Law, Policy, and Ethics, and Patrick J. Kennedy to curb discrimination against mental illness and to expand access to meaningful treatment.
National Association of Insurance Commissioners can connect individuals with state insurance boards for general information regarding insurance laws and filing a complaint against and insurance company for delay in coverage/reimbursement. Offers an interactive map online to locate state-specific contact information at: https://www.naic.org/state_web_map.htm
- The Kennedy Forum provides state specific information on filing a complaint or appeal for denial of mental health services under “Resources” section. Also offers a Complaint Registry and a step-by-step guide too filing an appeal.
ParityTrack is for individuals who have been denied coverage for mental health services (higher copays, limits on the amount of time spent at treatment, high Rx costs, etc.). Go to the Know Your Rights-Common Violations page to find out if your rights have been violated and there is the option to register a complaint if you have been denied coverage for a mental health or addiction service. Their website offers legal information only- does not provide legal referrals or legal representation.
Know Your Rights: Mental Health Parity (SAMHSA) provides the following link https://store.samhsa.gov/sites/default/files/d7/priv/sma16-4971.pdf which contains a PDF providing information on Parity Law (financial requirements and treatment rules) and one’s rights relating to mental health and substance abuse disorder benefits. You can also contact SAMHSA at (866) 444-3272.