Description

Has a health plan contacted you, wanting to do a clinical review (also called a treatment review) of one of your clients?  Or have you received a claim or care denial, since the insurance plan feels your sessions aren’t “medically necessary”?

It can be nerve-wracking to face a call with an insurance care manager, knowing that if you don’t say the right thing your client may not get the care they deserve.

This package contains two lists and a helpful article that are guaranteed to help you prepare for any clinical review with a health plan care manager, or to help you advocate for the care your client needs when appealing a denial.

The package contains:

• A list of questions that you may be asked during a clinical review, allowing you to prepare in advance, so that you can be calm and confident on the day of the conversation
• A list of questions to use to interview your client before the review or before any claim appeal, so you can have all the facts you need to defend their care.
• The link to a detailed article about preparing for clinical reviews, so you can understand exactly what insurance plans are looking for — and what NOT to say

When you are prepared and self-assured when speaking about your treatment, case managers may be less likely to question your care decisions.  And many therapists say that after preparing using these question lists, the clinical review itself was easier than they could have imagined.

AFTER PURCHASE, you’ll be taken to a Thank You Page – scroll down and look for the two blue links to your question lists. You should also get an automatic email with the links, and a follow-up email with the links within one business day from our office. If you haven’t received them, check your spam folder, then contact us at orders@theinsurancemaze.com.