Mental health and insurance claims: Relief could be in sight

Fighting with insurance companies over whether or not they will cover a claim can be one of the most frustrating and agonizing aspect of working in the medical field. Too often, clinics and physicians spend so much time trying to get an insurance company to cover the costs of certain procedures that they lose time working with the patients who need them.

But insurance companies have been denying claims and delaying payments in Florida for too long. This can take a serious toll on patients and the people who provide the care they may desperately need. Sadly, there are people who suffer from serious health conditions and must either pay for treatment out-of-pocket or end up forgoing care altogether. For example, one woman who suffers from a mental condition has been unable to secure health insurance because her bipolar disorder is considered a pre-existing condition. She has to go to great lengths and expense to pursue the care and medication she needs. 

However, this could be changing under the terms of the Affordable Care Act.

The federal health care law is aimed at making health insurance easier for people to get at a more affordable price. Without this, people have had a difficult time getting claims for mental and physical treatment related to pre-existing conditions covered. In general, these people are be required to pay such a high premium for coverage that it becomes unaffordable. But even then it can still be difficult for health care providers to eventually collect payment from the insurance company in a timely manner. 

But under the terms of the Affordable Care Act, insurance companies will not be able to refuse coverage for people based on pre-existing conditions. It could also make it easier for health care providers to secure payments from insurance companies without having to go through so many obstacles.

People should not have to fight so hard for their healthcare to be covered by insurance. Yet, the reality is that many insurance companies will try to deny claims and delay making payments in the interest of making a profit. While legislative actions may have a dramatic effect on this frustrating habit, it is also possible for people to take legal action against an insurance company who has wrongfully denied or delayed a claim. 

Source: Miami Herald, “Health insurance within reach for bipolar sufferer,” Kelli Kennedy, Sept. 11, 2013

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