State, UConn To Create Mental Health Claims Tool
The conversation about how to help 1.8 million privately insured Connecticut residents gain access to mental health treatment started long before a gunman killed 26 people at Sandy Hook Elementary School.
The effort began last spring when Deputy Insurance Commissioner Anne Melissa Dowling met with officials from the University of Connecticut Health Center.
Dowling recalled speaking with UConn about the Insurance Department’s ability to review denial and utilization rates for mental health services. She said UConn had stronger expertise in the area than Insurance Department personnel, so they decided to team up and create a tool to help consumers better navigate mental health claims. That’s in addition to the quantitative work on mental health parity that the Insurance Department will be mandated to do under the gun legislation passed last week.
The move, which Dowling called a “happy coincidence,” was praised by Gov. Dannel P. Malloy in a press release about the collaboration on Tuesday.
“No one should have to overcome mountains of red tape when they are trying to access mental health services,” Malloy said. “This collaboration allows us to leverage the respective expertise of the Insurance Department and the UConn Health Center to put in place a common-sense approach to what can be a profoundly frustrating process.”
The Insurance Department and UConn Health Center will work together to develop a user-friendly “claims tool” that will help consumers and providers, who often operate out-of-network on a cash basis, file their claims.
Mental health and behavioral health treatments are often denied because of incomplete or inaccurate claims, Dowling said.
“It’s been the Department’s observations that incomplete or incorrect information, coding errors, and other documentation issues are often the cause of claims denials requiring multiple appeals. We don’t want families having to fight to get the care they need,” Dowling, who oversees the department’s health insurance initiatives, added.
Reducing the number of insurance denials will increase access to services, even if reimbursement comes after the visit, Dowling said.
Scheduled for completion this summer, the claims tool kit is the first in a series of behavioral health projects the Insurance Department and Health Center are undertaking to assist consumers and providers. Work also includes enhancements to education and outreach materials for mental health insurance coverage.
“We are delighted to work with the Insurance Department on this important initiative and to share our world-class psychiatric and clinical expertise,” Dr. Frank M. Torti, UConn Health Center executive vice president for Health Affairs and Dean of the Medical School, said in a press release. “This project has the potential to improve the quality of life for so many of our families and especially the children.”
The collaboration and the creation of the tool kit won’t cost the state any additional money since the UConn Health Center already has a relationship with the Insurance Department.