Help After Bipolar Treatment Denial
Bipolar disorder can result in mood swings that go from extreme highs to extreme lows. During the manic phase, an individual with bipolar disorder may experience extremely high energy levels, impulsive behavior, agitation, and high levels of excitement. During the depressive phase, symptoms can include low self-esteem, feelings of worthlessness, lack of energy, and even suicidal thoughts. Bipolar disorder can color every single aspect of your life, altering the way you perceive everyday life and situations. Bipolar disorder affects about 2.8 percent of American adults, and approximately 83 percent of cases are classified as severe.
If your doctor has prescribed a specific treatment for your bipolar disorder, you may be feeling hopeful about your future. Then, when your insurer denies that treatment, you may feel hopeless and overwhelmed. This is not a situation you should face alone. The Law Offices of Scott Glovsky have been helping people in similar situations for many, many years. Attorney Scott Glovsky will fight for you and your future at every turn, never backing down from a large insurance company.
Why Might Your Bipolar Treatment Be Denied by Insurance?
Despite parity laws, mental health treatments are much more likely to be denied by insurance companies. In reality, any treatment for bipolar disorder that is costly is likely to be denied. Your insurer is required to inform you in writing why your claim is being denied. This could have to do with something relatively simple—and fixable—like an omission or error on a submitted form, or could be the result of a failure to receive treatment from an in-network provider, or because the bipolar treatment is not covered under your policy. The more nuanced insurance denials may claim the bipolar treatment denied by insurance is experimental, investigational, or not medically necessary.
What Should You Do About Bipolar Treatment Denied by Insurance?
When your bipolar treatment has been denied by your insurer, your first step should be to look at your policy to determine whether the treatment is excluded. Your insurer must provide you with information regarding how it determines medical necessity criteria, or how a treatment is deemed experimental or investigational. You can file an internal appeal with your insurer, asking that it take a second look at the denial, and reconsider its initial decision. If this appeal is not successful, don’t give up. You can file an external appeal with a neutral third party which may allow you to receive the bipolar treatment(s) you need. We recommend you speak with an experienced insurance attorney prior to submitting an external appeal because he (or she) can help guide the next steps.
What Are Some of the Most Common Bipolar Treatments That Could Be Denied by Insurance?
Bipolar disorder is a lifelong condition that can benefit significantly from specific treatments, including:
- Medications like Carbatrol, Depakote, Lamictal, and Lithium can stabilize your mood, treating and preventing highs and lows, while keeping your moods from interfering with work, school, your social life, and your day-to-day activities.
- The FDA approved the medication Fanapt (iloperidone) on April 2, 2024 to treat adults with bipolar | disorder in which patients have manic episodes lasting a minimum of 7 days, or severe manic symptoms such as extreme mood swings.
- Day treatment programs that provide support and counseling
- Substance abuse treatments for those with alcohol and drug problems
- Hospitalization including a partial hospitalization program, an intensive outpatient program, and residential treatment center programs in more extreme cases or when you feel suicidal or feel detached from reality
Getting the Help You Need from the Law Offices of Scott Glovsky
For bipolar treatment denied by insurance, you need experienced, skilled assistance from the Law Offices of Scott Glovsky. We will thoroughly assess your situation and circumstances, assisting you in filing appeals and combatting bad faith on the part of your insurers. Your very future can depend on receiving the treatment your doctor believes is best for your bipolar disorder. We will help ensure you receive that treatment. Contact the Law Offices of Scott Glovsky today—speak to Attorney Scott Glovsky who literally wrote the book on fighting insurance denials.