Insurance provider is going to stop paying claim for mental health care of a minor, while in a facility program. What can we do

Asked about 1 year ago - Orange, CA

Teenage minor is in a secure facility in Reno, NV as none in CA are allowed to lock doors. Facility was on their Anthem Blue Cross provider list- minor is mid-treatment, and they said as of yesterday will no longer pay, go pick her up about two hours ago.

Attorney answers (1)

  1. Tracy Green

    Pro

    Contributor Level 10

    2

    Lawyers agree

    Answered . There is not enough information to give a thorough answer, but you would need to talk to the facility to find out the reason the carrier denied coverage. See if the facility can help you appeal. I would also contact the carrier and find out the facts and see what you can obtain in writing so you can determine what your rights are on behalf of the minor. Is it a medical necessity issue? Coverage issue or other problem relating to the provider being used?

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