Dear Insurance Company:
We have received the initial denial of authorization from your office. As a matter of course in our effort to advocate for the needs of our daughter we requested the copies of all documents, records and other information relevant if we wanted to file appeal for benefits. We weren’t necessarily interested in appealing the Insurance Company’s decision because our daughter is a “special needs” adoption from the foster care system and we have alternate insurance choices. Makala continues to receive the recommended care as a residential patient.
We requested the documents in order to keep records of everything we do to help Makala. It has become clear that none of the professionals involved communicate with each other, and our primary and secondary insurance coverage only has parts of her history. Upon review of the records we obtained we would like the insurance company to correct the errors, omissions and inconsistencies.
Attached please find an itemized page by page listing of corrections that need to be made to the documents you have on your records. We have reviewed all the pages you sent to us with the information you used to determine that our daughter did not need continued mental health treatment. It is clear in reading your documentation that you do not have enough information to have made an informed decision.
Please add the attached documentation to your records so that if there should be a future need you will have a more complete and accurate record of the nature of care you decide to deny.
Of the greatest concern is that you immediately correct the record and stop listing us as anything other then “Adoptive” parents. Throughout your records you refer to us as Step, Biological and Adoptive parents. Your records also indicate that you sent these records to the “Biological” mother, I should hope this is just a mistake and assume it must be as the biological mother has no right to any of these records.
Thank you for your prompt attention to this issue and please feel free to contact us should you have any questions.
Blogs In This Series:
- Mental Health and Insurance: Advocating for Makala.
- Doctor-To-Doctor Review: Employer Provided Group Health Insurance
- Initial Denial of Authorization: The Letter.
- Copy of All Documents, Relevant to Your Appeal
Glossary of Insurance Terms:
A | B | C | D | E | F | G | H | I | J-K | L | M | N | O | P | Q-R | S | T | U-V | W-Z
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