Four Things You Should Know During Treatment in California
Seeking Legal Assistance for Treatment of an Eating Disorder with Kantor & Kantor, LLP
At Kantor & Kantor, LLP, we understand that dealing with and seeking treatment for eating disorders can be emotionally and financially devastating. When your health insurance company denies payment for benefits, matters only go from bad to worse. We can help.
Use the tips below to advocate for insurance coverage for eating disorder treatment:
- Once your claim has been denied by your insurance company, contact Kantor & Kantor, LLP for help. Until you have an actual denial in writing, your insurance company may change its mind and cover your treatment.
- In order for us to help you, you must receive treatment and stay in treatment, even after a denial of benefits. You must be able to STAY in treatment.
We understand that treatment is extremely costly. When your insurance company denies coverage, this can become an even more stressful time focused on financial burden rather than recovery and treatment. In order for you to focus on recovery, we advise following your treatment providers' recommendations for treatment protocol, level of care, and length of treatment. Let us work with your insurance company to help with that part of your journey. We will seek reimbursement of the benefits available under your policy.
In order for us to seek reimbursement, the law requires proof of an outstanding bill or payment for the treatment:
- Under ERISA (Employee Retirement Income Security Act), you have the right to file a lawsuit to recover unpaid benefits. If you do not have unpaid benefits, there is no ERISA claim. If you have been denied benefits by your insurance company for treatment, but leave treatment without paying anything out of pocket, you do not have unpaid benefits. We encourage clients to seek proper treatment based on their treatment providers' recommendations, not the treatment dictated by the insurance company.
- Know your policy/plan! Request a copy from your employer or the insurance company and become familiar with it. They are required to give you a complete copy upon your request. Every plan has its own rules and timing limitations with regard to submitting appeals and filing a lawsuit. Each plan and every state has its own requirement as to how long you have to act. We have encountered statute of limitations from as little as 30 days to as long as four years. Don't let this prevent you from pursuing an appeal or litigation.
Keep these steps in mind when beginning your recovery journey. If your health claim is denied, following these simple guidelines will make it much easier to get your benefits recovered.
About Kantor & Kantor, LLP's Eating Disorder Practice
Kantor & Kantor, LLP has developed a specialized legal practice representing clients whose claims for treatment of eating disorders, and dual diagnosis (substance abuse and other co-morbid conditions) have been unfairly denied by their health insurers or benefit plan. Kantor & Kantor, LLP's aggressive approach to litigation and legislation has brought justice for clients who have found themselves fighting for their insurance benefits when benefits were wrongfully denied. Unlike other firms, we work on a contingency fee basis, meaning we do not collect a fee unless we get your claim paid.
Please call us at (877) 740-6576 with any questions for a no-cost consultation. We understand and can help.
“Your kindness will never be forgotten.”- Lori & David
“First of all, I want to express my extreme gratitude for probably saving my daughter's life.”- Anonymous
“I won the appeal.”- Terry S.