E3 - Overcoming Insurance Obstacles to Care: Resources and Actions for Patient Advocacy

Learning Objectives:

• Identify common insurance company obstacles to mental health and substance use disorder care, particularly “not medically necessary,” “no in-network provider,” and barriers to telehealth access.
• Gain familiarity and confidence of the use of medical necessity letters, including their recommended content, clinical occasions for use, and success stories with their use across the continuum of care.
• Develop enhanced preparation and documentation skills for peer-to-peer reviews with insurers: related to prior authorizations, imposition of “step therapy,” pushback to frequency/duration of care, medical necessity reviews, and progress reviews.