Quote:
Originally Posted by 1914sierra
Your T will go through the appeal discussion with insurance (unless he's already had that discussion with them). Try not to panic quite yet. Generally they will go with the therapist unless you don't have a solid Axis I diagnosis.
Why did you and your T predict this would happen? Is it just routine for your insurance to automatically deny? Some are just doofuses that way. My insurance actually used to call and speak to my T every so many months, and I don't know what he said, but they never denied more sessions. (I don't think they even bother to check with him anymore after all these years. They just automatically approve.)
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We both just found out about the denial today
Both me and my T are going to try to appeal. I've already fax a letter to a senator and wrote a letter to the director of the department of health care services. I also have an advocacy number I'm going to call tomorrow.
I have Medi-Cal (California's medicaid). They typically only approve 16 sessions a year for therapy for adults. Medi-Cal did give me 32 sessions... But for my disorders, that is like 1/8th the time I need. So my T and I were prepared for a denial...but we just kept hoping for the best.
My diagnoses are MDD, BPD, and GAD. I definitely meet their criteria. I also have the support of my psychiatrist and probably my primary doctor.
Medi-Cal wants me to seek assisstance through other avenues in the community. The problem is, I have. Nothing exists for me