Denied for Mental Health Treatment? Here's What You Can Do

Episode Summary

In this episode of From the Clinic to the Courtroom: Health Law Unpacked, host Kevin Rosenquist is joined by Maria T. Santi, Esq., founder and managing partner of the Health and Medicine Law Firm, to unpack the frustrating—and often confusing—reality of mental health treatment denials by insurance companies.

Maria dives into:

• Why these denials happen
• The different levels of mental health care
• How the Mental Health Parity Law impacts coverage
• Steps patients and families can take to fight back
• What documentation is essential in legal appeals
• Why persistence and proper legal support can make all the difference

Whether you're a patient, parent, provider, or policymaker, this conversation sheds critical light on the legal rights surrounding mental health care access.

Timestamps

• 00:01 – Welcome to From the Clinic to the Courtroom
• 00:35 – Why insurance companies often deny mental health treatments
• 01:10 – Levels of mental health care and how insurers determine coverage
• 02:31 – Has access to mental health treatment improved?
• 03:09 – How mental and physical health are treated differently by insurers
• 04:47 – Do insurers have to follow the Mental Health Parity Law?
• 05:42 – What to do if your mental health treatment is denied
• 07:07 – How successful are appeals, and what affects outcomes?
• 08:03 – How providers can help strengthen an appeal
• 08:32 – What needs to change to improve success rates
• 09:20 – What patients and families should keep in a documentation file
• 10:30 – How personal and family history may factor in
• 12:33 – Questions lawyers ask to evaluate a denial case
• 14:08 – The financial incentives behind insurance denials
• 15:22 – Know your rights and don’t give up

About the Show

From the Clinic to the Courtroom: Health Law Unpacked brings you inside the intersections of healthcare, insurance, and law with Maria T. Santi, Esq., a seasoned health law attorney and founder of the Health and Medicine Law Firm. Each episode provides practical legal insights and real-world strategies for patients, families, and providers navigating complex healthcare challenges.