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Old Sep 14, 2008, 06:22 PM
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whales75 whales75 is offline
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Member Since: Jun 2008
Location: Minnesota, USA
Posts: 40
HI
Just as a tip, You need to ask your insurance carrier, if your plan is self funded or fully insured. Fully insured plans have to follow state mandates where you reside, self insured ones do NOT, they only follow ERISA..

Even if it's self insured, go through the appeal process. There is one if it follows ERISA ( a federal law)... Sometimes, the insurance company will allow an alternate benefit exception as it's more cost effective for a borderline to go to outpatient therapy vs inpt or thru the ER.. I appealed twice with mine and was granted extra visits.. My therapist had to write a letter of medical necessity but it was worth the extra effort. Hope that helps..
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Whales 75

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