1. There is someone to help you. Staff of the Maryland Parity Project is available to help you with the paperwork, the research and the phone calls. We understand most people don’t have time to deal with these tedious details which is why we will do most of the leg work.
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2. Complaints demonstrate the scope of the problem. The regulators have asked to see specific cases where violations have occurred or where the regulations may be unclear or ambivalent. We have a small window of opportunity before the final regulations are written and published. If we want our voices heard, we must bring the regulator’s attention to the consistent problems.
3. Appeals and complaints are often found in favor of the consumer. A 2010 report by the Maryland Insurance Administration showed that 60% of complaints of adverse decisions (denial for reasons other than lack of covered benefit) are either reversed by the insurer or overturned by the MIA.
4. You can help change the system so someone else does not have to go through the same difficult process. We understand the appeals process is tedious and time consuming, but if you take time to work with us and file an appeal, you be may be successful in getting reimbursement for treatment. In addition, the insurer may decide to change a questionable policy or may be forced to do so by the MIA or DOL. Your efforts may save others the time in filing an appeal and may give them access to treatment that might otherwise be denied. Our goal is to change systems to benefit the individual.
5. Without complaints the insurers have no reason to change their policies. There are areas of regulations where insurers and those of us in the mental health community disagree. Insurers believe they are in compliance with the law, and until we can prove otherwise, they will continue their business as usual. We must force them to comply with the intent of the law, closing loopholes in the process.