My daughter was addicted to drugs and had drug induced psychosis. Her psychiatrist sent her to an outpatient rehabilitation facility but she was not able to participate because of her state. He then recommended an inpatient facility.
I called UBH to find out an in-network provider and drove her over 200 miles to the facility. She registered and was staying at the facility but a week or so later, UBH sent a letter denying pre-certification. My husband and I made the decision to let her stay there to receive the help she needed with the intention of appealing the decision. After her release, we went through the appeal process to no avail. The facility required that we pay upfront for ther stay and they charged $38K.
I can't understand how they can dismiss a claim because "their doctors determined the level of care was not required". Her doctor and the outpatient facility both told us that in patient care was required.
I checked her benefits online and it states that if there is no pre-certification, UBH would pay at 50% but they also denied that. What is curious is that they did pay 20% of the claim.
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