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Best Practices Guide to Improve the Parity Complaint Process
This guide offers best practices to improve the consumer complaint process and parity problem identification and describes state models for each practice. It also includes a model parity complaint form and implementation guidance to help stakeholders adopt the strategies most appropriate for their state.
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Consumer Health Insurance Knowledge and Experience Survey: Report of Findings
This report details the findings of a survey conducted by Public Health Management Corporation in five states (Illinois, Maryland, New Jersey, New York and Ohio) to better understand consumers’ experiences related to accessing mental health and substance use services and their understanding of the Parity Act.
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Provider Parity Act Knowledge and Practice Survey: Report of Findings
This report details the findings of a survey conducted by Public Health Management Corporation in five states (Illinois, Maryland, New Jersey, New York and Ohio) to better understand providers’ experiences related to addressing patients’ access to mental health and substance use services as well as provider understanding of the Parity Act.
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Mental Health and Substance Use Disorder Denial Tracker for Providers
This tool is designed to help providers track problems their patients face in getting their health insurance plans to cover mental health or substance use disorder (MH/SUD) treatment services.
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Help Patients Respond to Insurance Barriers
Tips for treatment providers on helping patients when insurers deny or limit their mental health or substance use disorder treatment.
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Your Insurance Rights
Five tips to help you understand your mental health and substance use disorder treatment rights.
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Parity Warning Signs
Three parity warning signs to help you determine if your insurance company is violating your right to equal mental health and substance use disorder treatment.
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State Attorney General Parity Act Enforcement Toolkit
This Toolkit has been created specifically for State AGs to promote an understanding of the Parity Act and provide specific actionable steps to achieve parity’s full promise through active enforcement.
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Consumer Inquiry and Response Center (CIRC)
Obtain answers to any questions or open formal complaints through multiple outreach channels through the state of New Jersey’s Department of Banking and Insurance.
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Parity Implementation Coalition
Obtain resources and information designed to help you communicate with plans, address disputes and better understand basic appeals rights and procedures.
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What You Need To Know About Mental Health Coverage
Addresses a variety of parity topics through a question and answer format.
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External review
Provides a brief step-by-step section on filing an external review. Describes when a consumer can file an external review, consumer rights related to external review, where to look for additional information about external review, length of time, cost, and assistance available in filing external appeal.
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How To File An Internal Appeal
Provides a brief step-by-step section on filing an internal appeal through your insurance provider. Also includes FAQs covering topics such as necessary documentation; when consumers can file appeals; length of the review process; and expedited appeals.
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Warning Signs: Plan or Policy Non-Quantitative Treatment Limitations (NQTLs) that Require Additional Analysis to Determine Mental Health Parity Compliance
Provides a number of examples to illustrate different treatment limits.
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Red Flags! Your Health Plan May Be Violating The Law
Learn how to identify parity violations when it comes to your health insuance plan and their coverage of substance use disorder and mental health care.
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File a Consumer Complaint
Provides an opportunity to file a complaint directly with a state’s insurance department.
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Model State Parity Legislation
Explore model legislation that targets critical areas that must be addressed to ensure that coverage for mental health conditions and substance use disorders is equal to coverage for other medical conditions.
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Parity Track
Track legislative, regulatory, and legal parity activities in all 50 states and at the Federal level to monitor implementation and best practices.
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Parity Partner Toolkit
A toolkit containing downloadable resources to help promote the use of Parity Registry and Parity Track.
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Parity Registry
A website where consumers can learn to file an appeal with their health plan after being wrongfully denied coverage for mental health or addiction treatment services.
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Advocacy and Health Insurance Coverage Template Language
Template language for individuals who are advocating for better coverage of substance use and mental health services in their health insurance plan.
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Parity Infographics
Six downloadable infographics that include impactful statements, facts and figures for use on social media channels.
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Mental Health and Substance Use Disorder Denial Tracker for Providers in New Jersey
This tool is designed to help providers track problems their patients face in getting their health insurance plans to cover mental health or substance use disorder (MH/SUD) treatment services in the state of New Jersey specifically.
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Ohio Toolkit
This toolkit includes information on basic insurance rights, parity violation warning signs, and how to file an appeal with Medicaid as well as private insurers in Ohio.
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New York Toolkit
This toolkit includes information on basic insurance rights, parity violation warning signs, and how to file an appeal with Medicaid as well as private insurers in New York.
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New Jersey Toolkit
This toolkit includes information on basic insurance rights, parity violation warning signs, and how to file an appeal with Medicaid as well as private insurers in New Jersey.
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Illinois Toolkit
This toolkit includes information on basic insurance rights, parity violation warning signs, and how to file an appeal with Medicaid as well as private insurers in Illinois.
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Maryland Toolkit
This toolkit includes information on basic insurance rights, parity violation warning signs, and how to file an appeal with Medicaid as well as private insurers in Maryland.
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Insurance Navigation Seminars
Attend in-person meetings to understanding what’s covered, how to optimize out-of-pocket cost savings, and how to fight back if coverage is denied for treatment.
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Your Insurance Questions Answered
Utilize insurance specialists to help you navigate the insurance landscape and answer questions about private insurance, Medicaid and Medicare coverage.
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Maryland Office of the Attorney General, Health Education and Advocacy Unit
Resource for mediation services to Maryland consumers who have a billing dispute with their healthcare provider or a coverage dispute with their HMO or health insurance company
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Maryland Insurance Administration Consumer Appeals/Grievance Information
Overview of the process for filing a consumer appeal/grievance with the Maryland Insurance Administration.
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New York Attorney General: General Health Care Complaint Form (Online and Printable)
General Health Care Complaint form for the New York State Attorney General’s Office.
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New York Department of Health
Information and resources regarding filing a complaint against a managed care plan in New York State.
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New York State Department of Financial Services Consumer Complaint Information
Overview of the process for filing a consumer complaint with the New York State Department of Financial Services
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New Jersey Department of Banking and Insurance Managed Care Plan Complaint Form
Complaint form for persons covered under a managed care plan in New Jersey.
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New Jersey Department of Banking and Insurance Managed Care Plan Complaint Information
Overview of the process for filing a consumer complaint for a person covered under a managed care plan in New Jersey.
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New Jersey Department of Banking and Insurance Consumer Complaint Form
Consumer complaint form for the New Jersey Department of Banking and Insurance.
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CareSource (OH Medicaid) Grievance/Appeal Information
Overview of covered person’s rights related to the CareSource (OH Medicaid) grievance/appeal process.
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CareSource (OH Medicaid) Grievance/Appeal Form
Complaint form for persons covered under CareSource (OH Medicaid).
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Ohio DOI Consumer Complaint Form
Consumer complaint form for the Ohio Department of Insurance.
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Ohio DOI Consumer Complaint Information
Overview of the process for filing a consumer complaint with the Ohio Department of Insurance.
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Office of the Attorney General for the State of Illinois: Getting Help with Mental Health and Substance Use Disorder Claim Denials
Information regarding red flags for potential parity law violations and resources for filing a complaint with the Illinois Attorney General’s Health Care Bureau.
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Illinois Department of Healthcare and Family Services
Information regarding filing a complaint with the Illinois Department of Healthcare and Family Services.
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Illinois Department of Insurance Consumer Complaint Information
Overview of the process for filng a consumer complaint with the Illinois Department fo Insurance.
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Illinois Department of Insurance Consumer Complaint Form
Consumer complaint form for the Illinois Department of Insurance.
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Illinois Attorney General Health Care Bureau
Resources to help consumers with difficulties they encounter in obtaining health care services and insurance benefits through mediation, investigation and enforcement actions.
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Illinois Insurance Facts
Information about mental health and substance use disorder insurance coverage from the Illinois Department of Insurance.
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Working Group Regarding Treatment Coverage of Substance Abuse Disorders and Mental Illness Annual Report
A list of the health care insurance carriers, mental health advocacy groups, substance abuse patient advocacy groups, and mental health physician groups, details on the issues and topics covered, and legislative recommendations as required by statute.
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Mental Health and Substance Use Disorder Parity: What Consumers and Providers Need to Know
An overview of key insurance terms and where to get help.
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Baltimore City Crisis Information and Referral Line
Baltimore City CIR: Mental health and Substance Use Disorder crisis support and treatment referral hotline from the Baltimore City Health Department for those in Baltimore City, MD.
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Maryland Health Connection – “Choosing a Health Plan: Substance Use Disorder Treatment”
Information regarding Substance Use Disorder treatment coverage for consumers purchasing health plans through the Maryland Health Connection.
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Maryland Department of Health, BH Administration – SUD Treatment Services Locator
Database of state-certified Substance Use Disorder treatment programs in Maryland.
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MD Dept. of Health, BH Administration – “Before it’s too Late” Crisis Hotline
Before it’s too Late Crisis Hotline: Crisis support and treatment locator for mental health and Substance Use Disorder services from the Maryland Department of Health, Behavioral Health Administration.
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OH Dept. of Mental Health and Addiction Services Crisis Text Line
OhioMHAS website and “4Hope” Crisis Text Line: Crisis support and treatment resources for mental health and Substance Use Disorder services in Ohio.
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IL Dept. of Health and Human Services MH Treatment Locator Resources
Crisis support and treatment locator for mental health services from the Illinois Department of Health and Human Services.
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IL Dept. of Health and Human Services SUD Treatment Locator Resources
Illinois Helpline for Opioids and Other Substances: Resource for finding Substance Use Disorder services from the Illinois Department of Health and Human Services.
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Addiction Open Access 24/7 Hotline
Hotline for individuals with SUD & their families in Western NY.
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“Got5” Crisis Text Line
OMH Website and “Got5” Crisis Text Line: Mental health crisis support and treatment resources from the NYS Office of Mental Health.
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HOPE-NY Hotline
HOPE-NY Hotline: Information and referrals for SUD from NYS Office of Alcoholism & Substance Abuse Services.
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NYS Office of Alcoholism & Substance Abuse Services Treatment Availability Dashboard
Resource to search for state certified outpatient or bedded programs in New York.
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Accessing Insurance Coverage For Substance Use and Mental Health Treatment Training Video
Recorded webinar explaining parity and related laws.
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New York Attorney General’s Parity Enforcement Resources
A summary of the New York Attorney General’s settlements finding parity violations.
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New Jersey Dept. of Health, Division of Mental Health and Addiction Services Treatment Locator Resources
Treatment locator for MH/SUD services from the State of New Jersey Department of Health.
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Consumer Toolkit for Navigating Behavioral Health and SUD Care Through Your Health Insurance Plan
Includes things like a glossary of terms and a checklist of the best things to ask your health insurer and your doctor so your health plan pays for the appropriate care.
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Consumer Guide to Understanding Your Health Insurance Coverage for Mental Health and SUDs
A toolkit to help MD residents better understand insurance coverage for mental health and substance use disorders.
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Mental Health and SUD Coverage FAQ
Provides general information and guidance about insurance coverages and laws in Illinois.
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Illinois Department of Insurance Jennifer Hammer Answers Questions on Mental Health Parity
This video addresses parity, substance abuse treatment and how to get assistance if you believe your insurance company has unfairly denied you coverage.
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Understanding Your Mental Health and Substance Use Disorder Benefits – Infographic
Helps consumers in Ohio understand the Parity Law and steps to take to see if you have coverage.
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Parity Guide Sample Letters
Provides sample letters for appeals and requests for documents.
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Has Your Health Insurer Delayed or Denied Substance Use Or Mental Health Care? They May Be Breaking the Law!
Explains the appeal process to challenge insurance denials and adverse decisions in NY.
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Health Insurance for Addiction & Mental Health Care: A Guide to the Federal Parity Law
An overview of the federal parity law; information on how to identify what type of health insurance plan you have; actionable steps and support resources, including sample complaint letters if you believe your plan is violating the law.
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Issue Brief: IL Providers Report Barriers to Mental Health and Addiction Coverage
An overview of the barriers Illinois providers and patients face while seeking treatment for mental health and addiction coverage.