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RetroIsBack t1_ja6876y wrote

If you have insurance, The NH state insurance department is really good about forcing insurers to pay for "medically necessary" treatment as part of the appeals process. That applies to mental health treatment, but also applies to esoteric immune disorders with very expensive medications and some cancer treatments.

You must have good medical records, especially if the disease is chronic. Honestly, if you have good records that show other treatments have not worked, you don't even need to get a doctor involved.

  1. You are denied.
  2. Get the appeal forms from the state insurance company.
  3. Follow the instructions..attaching id, denial letter, proof of insurance, medical records
  4. Scan to Pdf
  5. Email/mail/fax to state
  6. It gets sent out to a 3rd party review. The treatment has to have been proven to be effective for treating the illness in general per FDA--not experimental--, it has to be a medical procedure, and other alternatives have not worked (your medical records)
  7. It comes back with approval or denial from 3rd party reviewer...a firm out of state with physicians and nurses who review your records....
  8. State issues order to insurer (very quickly)

If approved, the insurer has to pay. At this point the insurer is going to assign a single person to you to process everything because losing an appeal is a black mark on their record. Don't give them any info about the illness or progress, just ask them questions if necessary. If they create any more problems, such as limiting you to their pharmacy, tell them you are going back to the state.

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greenglasstree t1_jaa4b9l wrote

Health resources in general are craptastic in New Hampshire. Both mental and physical.

My friend's father shouldn't have to drive to another state just because he has a relatively uncommon disease and the specialists in NH suck.

New Hampshire needs to stand on its own feet and provide health services and jobs for its own people.

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thescreamapillar t1_jaca7xd wrote

Literally had ONE Rheumatologist accepting new patients—after months I finally have an appointment at the end of March. I booked this when it was still warm out…

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greenglasstree t1_jacc91m wrote

And the ones that do exist suck.

It doesn't matter if it's rheumatology, gastroenterology, or immunology. The most competent specialists, who can give accurate diagnoses, live in 6 cities and almost nowhere else.

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thescreamapillar t1_jacafo2 wrote

If you need AUD/OUD/SUD treatment, harm reduction, and recovery services, please reach out—I can at least help in that aspect: email me!

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