Status of mental health care in America
In my attempt to provide care to those that suffer from mental health issues and substance abuse illness, I have run into a concerted effort by the insurance companies at large to stifle all efforts to provide this care. There chief mechanism is to deprive funding by denying all mental health claims . Infact, they have taken it to the next level and just not process the claims which is a violation of state law. The law clearly states that all valid claims must be processed in a reasonable time frame. Either deny or approve but they must process the claims. My experience has a fortune 500 insurance provider as just not processing the claim. They can’t legally deny the claim as the affordable care act mandates that all mental health and substance abuse treatment must be covered by all insurance providers. So their conspiratorial effort is to just not process the claim. This rose to the level of complaints being filed against the insurance company at the state level. The states response was they have no actual authority over the insurance providers as they fall under federal jurisdiction, which is Medicare and Medicaid and they offered to file a complaint on my behalf with these entities. These same insurance providers refused to answer the calls to the person assigned to handle my complaint, even refused to answer certified mailings. Outright refusal to process my mental health claims and deny any discussion on the matter. This blatant disregard of the Affordable care act flies in the face of reason. It outright circumvents all the efforts made to get the Affordable care act law to pass. What is the merit of having a law on the books, if insurance providers can just ignore the law of the land. At the heart of this is the adult men and women who are not served because of these actions. In speaking with an attorney who is familiar with this topic, he stated that insurance companies have adopted this as a company policy. To ignore or deny all mental health claims until forced to pay in a lawsuit. At that point they would pay those suing and sign a non-disclosure contract and thus not have to pay all the others being denied or ignored. This he stated is an actual business policy, thus elevating their bottom line. The fact is insurance providers make money when they deny claims. In my research I uncovered the fact that insurance providers are paid a set rate monthly for each Medicare and Medicaid member they cover. This rate is paid whether the member uses the money or not thus it behooves the providers to deny claims and keep the money in their coffers. Fact is the gate is being kept closed for mental health and substance abuse treatment, regardless of the law of the land. This disservice is being cast upon those who need treatment the most, with the rise in opioid related deaths and mental health crimes on the rise not to mention homelessness due to mental health and substance abuse illness. The fate of millions is being cast to the pits of failure due to insurance providers treating their bottom line better than their clients. The only method afforded this atrocity of care is open and repeated discussion. By placing the bright light of exposure on this concerted effort by the insurance providers can we have any hope of reversal of these actions. Please stand with me and make this fact known.