insurance Archives - Gateway Psychiatric

Insurance Coverage Denial – Appeal Process Overview

admin — Mon, 18 Apr 2022 14:53:04 +0000

My insurer refuses to cover my prescribed treatment. What can I do? If your insurer denies your coverage, you can challenge your insurer’s decision by completing the following steps in order: Appeal the Decision How do I appeal the decision? If your insurer denies your claim, you have the right to an internal appeal.[1] This means you can ask your insurer ...

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Medications for an Emergency

Peter Forster — Sun, 15 Mar 2020 20:29:30 +0000

Several people recently requested medications to have on hand in case an emergency disrupts the supply. Here are some guidelines for these requests. This is from a useful post written by a doctor after a local emergency… “Ask your doctor for an additional prescription, explain what you’re doing and tell your doctor the meds will be going into storage,” says ...

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Telemedicine Coverage Mandatory in California

Peter Forster — Fri, 13 Mar 2020 18:02:33 +0000

California Governor Signs New Telehealth Insurance Law On October 11, 2019, California Governor Gavin Newsom signed a new law requiring commercial health insurance coverage and payment parity for telehealth services, unfortunately the law won’t take effect until 2021. However, in consideration of the State of Emergency declared by the Governor and the Secretary for Health and Human Services, an industry trade group, America’s ...

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Webcam Appointments March 2020

Peter Forster — Fri, 13 Mar 2020 17:52:53 +0000

I will be seeing my patients via webcam for at least the next two weeks. Your appointment will be at the same time, but to join the meeting you will need a smartphone or computer with Chrome, Safari or Firefox and a camera. Most smartphones and computers (except for work computers that block video conferencing) should work. You can find out ...

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We Are Not “In Network” Providers

Peter Forster — Thu, 23 Mar 2017 21:46:50 +0000

Gateway Psychiatric Services is not an “in network” provider of care. Many of the patients we see get reimbursement for their care here, but this depends on the specific insurance plan and how it handles out-of-network claims. The most generous plans seem to be provided by larger “tech” companies which often have very generous out-of-network coverage. It is important to ...

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Requesting Out of Network Coverage for Psychiatrist

Peter Forster — Sun, 27 Nov 2016 20:16:18 +0000

EXTENDING MEDICAL BENEFITS TO NON-PREFERRED PROVIDER PHYSICIANS Some of the most heartrending calls that we receive from potential patients have to do with people who are unable to find psychiatrists who are covered under their insurance plan. One solution may be to request out of network coverage for a psychiatrist. Background There are several problems that make this a common ...

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Disability

Peter Forster — Sat, 05 Mar 2016 21:33:10 +0000

Given the severity of mood and anxiety symptoms and some of the people we treat, we often deal with issues related to short-term or long-term work disability. In this post we will talk about common questions that come up when someone is impaired as the result of a psychiatric condition. Functional Assessment It often comes as a surprise to our ...

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Medicare at GPS – Update 2022

Peter Forster — Wed, 30 Sep 2015 23:25:49 +0000

This is a fourth post to update our Medicare status. It is an update of the post from 2017. Provider Status and Volunteer Teaching at UCSF As of October 2015, Dr. Forster is no longer “opted out” from Medicare. This change was necessary for him to continue to serve as a volunteer clinical faculty member supervising residents in the Bipolar ...

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Parity Website

Peter Forster — Sun, 05 Jul 2015 19:13:20 +0000

We ran across information about a new website that is drawing attention to the issue of mental health parity and that is dedicated to helping people get the behavioral health treatment they need – Paritytrack.org. The essence of the federal law that requires mental health parity in insurance coverage is not that mental health needs to have a certain level of ...

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Prior Authorization Form – New Law in California

Peter Forster — Thu, 16 Oct 2014 18:26:03 +0000

Prior authorization forms for medications, and the entire prior authorization process, can be a nightmare. In my experience, with at least one company, the rule seemed to be, if you filled out a form you were told that you needed to call to obtain the OK, and if you called you were told to fill out a form. It was ...

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