The Insurance Appeal – insurance

I may have mentioned that my insurance has denied me coverage out of network because they feel in their wisdom – I use that word lightly – that they have specialist in their network. Of course they don’t because what specialist would ever work for a “paid fee – for – service on th basis of one national fee schedule? Really?? My psychiatrist hasn’t for years and that is why I’ve had him for 11 years! So I’m appealing their decision which I may do twice. It has taken me about a total of 30 hours of computer time to get it completed. I have to keep it I feel more technical and less emotional:

Dear  Representative,

Thank you for taking the time to review my appeal request in regards to providing the coverage out of network for my care with Dr. ***** . I am providing the following information in support of my case :

• Definition of Dissociation Identity Disorder
• The  list of providers who are contracted under my plan with my following criteria under “ Choosing the right clinician for you”
• Brief description of why I have chosen to begin therapy and the reason it is imperative the experienced psychologist meets my criteria in the safest way possible.
I have carefully read the Level of Care Guidelines a few times and years ago would have gone along with the current belief that there is a level of care provided throughout the  network qualified for every  client under the sun. But having been one of those “ clients” sent through the revolving doors of the mental health facilities for several years, putting up with therapist’s wearing pagers, dragging up my past when it is not necessary after a few weeks, calling me a liar, discontinuing therapy after a few months because “lack of progress”, not recognizing when I have switched and becoming angry when I seem to be locked in a no compliance “mood” – the list can go on for pages – I no longer agree with the professionals who say they are truly proficient in treating the dissociative identity disorder.
With modern technology therapy has taken on a whole new approach and along with it more responsibility I personally believe with both the client and the practicing psychologist. The psychologists who profess to specialize in one disorder, yet have more than fifteen “specialties” listed on their bio’s leaves me to question how any committee could agree to leaving these in-network psychologist in my care. I simply don’t have the time. I have done a lot of work in the 90’s but was unable to complete the work due to a corporate move. I have seen one therapist  in ( State) and it was the same result, after taking my money for almost a year, she concluded I was undermining my treatment and therefore I never came back. Pull up any of your contracted  employees and you’ll probably see most are experienced in treating this disorder. After spending a year with one and counting the number of times they look at their pager, you will begin to understand why I will not begin the process of elimination. I haven’t the time and I am well aware of it if you truly know about the dissociative identity disorder, you will know exactly what I know.

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About crystallball7

Creative,some say "eccentric", dark sense of humor,sensitive. Never the same for too long. Running from lost time. Longing to be on the beach, at the ocean, New England. Afraid of life, extremely afraid of life.
This entry was posted in bipolar disorder, dissociative identity disorder, Mental Illness, psychology; M.P.D., D.I.D. and tagged . Bookmark the permalink.

One Response to The Insurance Appeal – insurance

  1. Pingback: Mental Disorders 101

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