Insurance denying therapy claim because it’s "telehealth"
I submitted claims to my insurance for 2 months worth of therapy. It got denied because I talk to my therapist via telehealth. This provider was in-network with my old insurance, but my company got acquired and we got new insurance. She is now out-of-network.
The “Behavioral Health” section of my current insurance plan says: Out-of-Network: You pay deductible and out-of-network coinsurance. If you receive services from a noncontracted provider, you also pay the balance bill.
When on the phone with a rep from the company (BCBS of AZ), they said it was telehealth, and I had to look at the telehealth section of my coverage book. I had no idea that “telehealth” was considered a different service than behavioral therapy. It honestly still doesn’t make sense to me.
The telehealth section of the document says: Benefit-Specific Exclusions: Services delivered through the sole use of an audio-only telephone, a video-only system, a facsimile machine, instant messages, or electronic mail, unless otherwise required by law.
Do I have any hope here? Of getting my therapy reimbursed for past or future visits? Or am I screwed? You’d think that with covid that telehealth would be covered.
