United/Optum find new ways to deny payment for mental health claim

Therapy patients stop treatment after pre-payment reviews swell–United Health/Optum

United Health/Optum finds new way to avoid paying for mental health care.

“The impact of these reviews is raising concerns about delays in treatment (since many pts are holding off on additional sessions out of fear that the treatment will not be covered), patient privacy, delays in reimbursement, and unnecessary additional administrative burdens on psychologists,” wrote Dr. Jax Gallios, an out-of-network psychologist in New Jersey who submits bills to United on behalf of some of her patients. “It is also raising parity concerns, including further constriction of the already difficult access to mental health care through insurance.”

A West Coast therapist wrote: “I’ve had to reduce my schedule to 60% capacity” to meet the administrative burden. He said he had received dozens of record requests, followed by dozens of duplicate requests.

“Each new request takes 55 minutes to process, and each duplicate 22.5 minutes,” he wrote.