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11 Here are some tips to help you avoid or address problems with access to care through health insurance Know what your plan covers. Most insurers make this information available on the plans website. If you have questions about a service that is not listed call the insurer to be certain. Ask whether pre-approval or pre-authorization is necessary for services you havent used before. Make certain that authorization has been provided before you go for the service. Know how many visits are allowed. Certain services may have a cap on the number of visits particularly therapy services physical occupational speech or mental health. Work with your therapist to maximize your treatment during that number of visits. If the therapist feels it is medically necessary for your treatment to continue after the cap is reached you can appeal the cap. Ask for explanations. According to the American Medical Association an average of 9.5 percent of medical claims processed by private insurers contain errors. So when coverage is denied dont accept the simple answer. If you are told a claim is deemed not medically necessary not covered under your plan etc. probe a little deeper. Ask why. Dont hesitate to politely ask to speak to a supervisor or someone who can explain the companys position to you. Be detailed. Keep track of who youve spoken to at your insurance company and what was said. If cognitive issues prevent you from doing so use a speakerphone and ask a family member or friend to take notes.You will need this information to understand the companys case and form the basis for your appeal. Hurdle 3 I dont know when to ask for a referral. Office visits can go by very quickly and your doctor may not ask about every issue that is on your mind. It is important to speak up about any change in symptoms even if those symptoms are currently manageable. Early intervention by a specialist can often prevent symptoms from worsening. Some specialists can best serve you if youve had an evaluation soon after your diagnosis. This evaluation serves to establish a baseline and helps to monitor any changes over time. Other specialists are only needed when new or changing symptoms affect your health or ability to function independently. It may be difficult to gain insurance pre-authorization for baseline evaluations. Some providers choose to wait for the first report of symptoms to refer you to a specialist. This approach requires you to be active in noting and communicating changes in functioning to your healthcare provider.