Help After PTSD Treatment Denial
If you’ve been through a traumatic event, you may be diagnosed with PTSD, or Post-Traumatic Stress Disorder. PTSD is usually the result of a shocking, even dangerous event that happens to you or that you witness. You may even believe your life is in danger or that the lives of others are in danger during such an event. About six out of every 100 people (6 percent of the U.S. population) will experience some level of PTSD during their lifetime.
Women are more likely than men to develop PTSD (8 out of every 100 women vs. 4 out of every 100 men). This is due in part to the types of traumatic events women experience (like sexual assault) as compared to the traumatic events men experience. If your physician has recommended a specific PTSD treatment then your insurance company denies that treatment, you can feel frustrated, angry, and overwhelmed.
What Are Conditions Resulting From PTSD?
In a study published in May 2023, researchers found that soldiers who witnessed trauma had molecules that activated oxidative stress, inflammation, metabolic dysregulation, and issues creating new red blood cells. According to scientists, these four could impact not only psychological or mental health, but also physical health including cardiovascular health and even wound healing.
Why Might Your PTSD Treatment Be Denied by Insurance?
Like any medical treatment, a PTSD treatment is most likely to be denied when it will cost the insurer more money than a different PTSD treatment. In other words, the more expensive the treatment, the more likely it will be denied—although cloaked under denial words like “experimental,” “investigational,” and “not medically necessary.” If the treatment is a prescription medication, you may be required to go through “step therapy.” This means you have to start off with a less expensive drug, moving on to one or more slightly more expensive drugs before you can get the drug your doctor prescribed.
As you might imagine, this can be a lengthy, exasperating process. If your insurer simply denies the drug or other treatment altogether, it is time to get the Law Offices of Scott Glovsky involved. A PTSD treatment denied by insurance requires a strong advocate in your corner—someone who really cares about you, your health, and your future. Attorney Scott Glovsky is that person, fighting for you at every turn.
What Should You Do About PTSD Treatment Denied by Insurance?
A PTSD treatment denied by insurance requires very specialized assistance from a law firm like the Law Offices of Scott Glovsky. Scott and his legal team have a deep understanding of why insurers deny treatments—and how to ensure your insurer does the right thing. You may first need to file an internal appeal with your insurer, asking that it take a second look at the denial. If the PTSD treatment is still denied after this internal appeal, we can help you file an external appeal with a third party. The decision of this appeal is binding on the insurance company.
What Are Some of the Most Common PTSD Treatments That Could Be Denied by Insurance?
There are four interventions usually recommended for PTSD patients. These include:
- Cognitive Behavioral Therapy (CBT)
- Cognitive Processing Therapy (CPT)
- Cognitive Therapy or Counseling
- Prolonged Exposure
For very debilitating PTSD, a provider may recommend a more comprehensive program such as an intensive outpatient program, a partial hospitalization program, or a residential treatment center program.
The following treatments may be used in conjunction with the treatments above:
- Brief Eclectic Psychotherapy
- Eye Movement Desensitization and Reprocessing Therapy
- Narrative Exposure Therapy
- Medications like sertraline, paroxetine, fluoxetine, and venlafaxine
Which Insurers Are Most Likely to Deny Your PTSD Treatment?
Any insurer might deny your PTSD treatment, especially if it is a relatively expensive treatment. Some insurance companies are more likely to deny treatments than others. California health insurers that might deny your treatment include UnitedHealthcare, Anthem Blue Cross, Blue Shield, HealthNet, Kaiser, or Aetna, as well as others. Regardless of which insurance company denies your PTSD treatment, contacting the Law Offices of Scott Glovsky is an important stage in the process. With a history of impressive results against large insurance companies, attorney Scott Glovsky is ready to help you through this difficult time.
Getting the Help You Need from the Law Offices of Scott Glovsky
A PTSD treatment denied by insurance can benefit greatly from speaking to Attorney Scott Glovsky. Scott believes passionately in helping those who are struggling to get the treatments recommended by their doctors. At the Law Offices of Scott Glovsky, we will never hesitate to take on a huge insurance company, zealously fighting to get you the PTSD treatments you need. We will never allow an insurance company to take advantage of you, rather we will ensure they live up to their responsibility to you and your family. Contact the Law Offices of Scott Glovsky today.
