When mental health consumers use their insurance to pay for services, insurance companies may sometimes deny this service, or deny specific benefits. If consumers are denied, they do have the right to file an appeal.
The Ohio Department of Mental Health and Addiction Services (ODMHAS) and the Ohio Department of Insurance (ODI) would like to encourage mental health providers and consumers to be aware of their rights when it comes to filing an appeal. They have provided a handout which highlights the different appeals processes for private insurance, Medicaid, and ERISA plans. Providers can use this information to help clients who seek to appeal denied services or benefits. This information can also be used by providers to file appeals directly on behalf of their clients. This important handout can be found on the Ohio Department of insurance website here.
For even more information on how to understand health insurance coverage for mental health and substance use disorder benefits, see the Mental Health and Substance Use Disorder Benefits Toolkit on the Ohio Department of Insurance website here.