Denials Management, Inc.

12/02/2021

Do you have a background in insurance, advocacy, writing, or customer service and want to be part of a passionate team holding insurance companies accountable to their insured? We are looking for more people to add to our team to help the many family and facility clients we are blessed to serve! Message us for more details!

12/02/2021

Our team members are a “gift”🎁, so we created a hot cocoa bar for them to enjoy this month! We hope they’ll take a moment to sit, sip, and be “present”🎁!

05/05/2021

“Part of the problem is that people often do not complain when their insurer refuses to pay for treatment, said Volk, who has been working with state officials on the issue. She advised that anyone who is denied a claim for behavioral care should appeal it to their insurer and report it to their state’s insurance or labor department.”

We are here to help with appeals and insurance department complaints. Don’t take take the insurance company at their word! There is often coverage available, even when your insurance company says there isn’t.

A report from the Government Accountability Office paints a picture of an already strained behavioral health system struggling after the pandemic struck to meet the treatment needs of millions of A…

11/08/2020

“The behavioral health division of UnitedHealth Group can no longer use its own “overly restrictive guidelines” to deny mental health and substance use treatment, a federal judge ordered Tuesday. The company must replace them with independent rules that will lead the nation’s largest insurer to pay for more treatment and pave the way for more challenges to health insurers’ ability to set their own guidelines for what treatment is medically necessary.”

A federal court is requiring the behavioral health division of UnitedHealth Group to decide claims using less restrictive criteria.

07/20/2020

“Under the federal law known as COBRA, people who lose their job-based coverage because of a layoff or a reduction in their hours usually have 60 days to decide whether to continue with that same health plan. But under the rule issued this spring, that clock doesn't start ticking until the end of the COVID-19 "outbreak period" that started March 1 and it will continue for 60 days after the COVID-19 national emergency is declared to be at an end. That end date hasn't been determined yet.

With this extension of the time frame to sign for up for COBRA coverage, people have at least 120 days to decide whether they want to elect COBRA, and possibly longer depending on when they were laid off.”

People who lose their job-based health plan usually get 60 days to decide to continue it — and pay more — under federal rules. But a recent pandemic-related rule change allows more decision time.

07/17/2020

A big victory in the battle for parity!

“The state of Illinois has once again stepped up to lead by example in righting a wrong that impacts countless families…Access to affordable, in-network care is one of the most critical aspects of recovery from mental health and substance use disorders." – Patrick J. Kennedy

On Wednesday, July 15th, the Illinois Department of Insurance (IDOI) announced fines against five major insurance companies for violating the 2008 Mental Health Parity and Addiction Equity Act…

06/25/2020

Visit our website to download the Health Insurance Appeals Guide today!

ANNAPOLIS, Md. (PRWEB) June 25, 2020 -- Denials Management, Inc. has just published The Health Insurance Appeals Guide to inform consumers and treating providers on the key steps when filing appeals for denials of mental health and substance use disorder (MH/SUD) treatment services. It was written b...

06/19/2020

The definition of “Medical Necessity” varies from insurance company to insurance company, and there is a lot of subjectivity on the part of the insurer on what they consider to be medically necessary.

Congress required health plans to fully cover COVID-19 testing, but insurance companies are starting to argue they should only have to pay if patients show symptoms or tests are ordered by a doctor.

05/28/2020

Here at Denials Management, we know the struggle with the prior-authorization process far too well.

“The prior authorization process is a lengthy one, in which denials and appeals are often repeated several times for each patient. As one nurse told me: "the insurance company fights to deny, we fight for approval, and whoever is left standing at the end of the process wins."

Now is the time for permanent reform.

04/30/2020

It is important to protect our health during the COVID-19 crisis, but remember that our mental health can also be affected.

NAMI is now offering support groups seminars and other resources for free during these trying times.

To help Utahns through this difficult time, NAMI Utah is offering free online support groups, mental health seminars and educational workshops. The presentations will provide information on signs, symptoms, treatments and resources, according to a press release. To help Utahns through this difficult...

04/26/2020

In addition to refunding customers, Blue Cross of Texas will have to pay a $10 million fine.

“Blue Cross Blue Shield of Texas has agreed to repay consumers after state regulators found the health insurance company was mishandling out-of-network emergency claims and providing incorrect information.”

Blue Cross Blue Shield of Texas has agreed to repay consumers after state regulators found the health insurance company was mishandling out-of-network