Report: Magellan Behavorial Health
Category: Misc. Health Specialists
Magellan Behavorial Health Victimizes the victims again, unprofessional, uncaring, scum suckers Columbia Maryland
*Consumer Comment ..If they referred here, what makes them think they don't have to pay?
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Magellan Behavorial Health
Fax:
Columbia, Maryland, 21046
U.S.A.
Submitted: 5/7/2003 1:03:32 PM
Modified: 5/9/2003 10:05:36 PM
Sue
Vancouver, WashingtonMegallan is responsible for about 1 out of every 3 American's mental health care. My husbands indeminty plan pimped out the mental health part to these incompetent 'professionals.'
My daughter was coming off a 3 day run of crystal meth, threatening suicide (heard by police as well as school officials) and I was told she would have to 'flunk' out patient therapy at least once and more likely twice before they would put her into a rehab.
After brain storming with other medical friends (I was an RN for 20 years) I spoke with numerous staff at Magellan and was finally told of a rehab in Portland she could be evaluated at. After taking her there (upon there recommendation) her entire bill of $19,700 was refused.
According to many local psychologists I have now networked with, this is the NORM for this company. Unless a client has a knife sticking out of their chest, Magellan NEVER feels that anyone needs in patient therapy. (per the psych. at the facility) They refuse to put into writing their liability when it comes her surviving.
Please someone care enough to take this company down. You can read on the internet how many millions of dollars they have been fined for etc.
Sue
Vancouver, Washington
U.S.A.
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Updates & Rebuttals:
- Did you take her for medical evaluation first? Sherri [5/7/2003 10:39:06 PM]
- Answer to Rebuttal Sue [5/8/2003 1:52:38 PM]
- If they referred here, what makes them think they don't have to pay? Sherri [5/9/2003 6:00:51 AM]
Did you take her for medical evaluation first?
Crystal meth is a very nasty drug with lots of physiological as well as psychological side effect, and most of the time the 'down' is not considered a psychological disorder as much as a physiologic one and that may be what they are basing their denial on. The reason I ask about possible medical intervention first is that if there is documentation that your daughter was considered a threat to herself by the medical staff, it seems to me Magellan would have no alternative other than to pay it. It also seems to me that if there was documentation from a school counselor that your daughter vocalized these suicidal ideations, that should be sufficient. I am a Nurse Practitioner and I DETEST many insurance and behavioral health carriers, because they don't want to pay what they are contracted to pay.
Does the EOB explain exactly why they denied the claim? If not, I would send them a certified letter, return receipt requested, asking them for a detailed list as to WHY. If they refuse, contact your state insurance commission for assistance.
Good luck
Answer to Rebuttal
EVERY step was followed.(What Magellan staff told me to do) She did not need a medical eval rather she needed a psych eval that was NOT performed when she was in the local ER threatening suicide etc. In the state of WA children at the age of 13 can refuse medical treatment and as you know meth users never think they have problems. She did not even see a resident in the local ER. (Psych resident) A social worker had her make a verbal contract that she would not harm herself.How STUPID is that? I wish you could hear some of the stories I have been told by the psychologists in this area with their experiences with Magellan. My husband has an indemnity policy since he is retired on disability from Prudential. I had contacted the insurance commissioner in 4 different states and they can not do anything because of it being an indemnity policy. So I contacted Washington DC and was basically told that they can do anything they want. (Prudential) I truly know the meaning now of going 'postal', when you are fighting to try to save someone life and fall upon deaf ears. Mental health has always been covered by insurance companies at a very poor rate compared to the medical rate. Since I had never needed these services previously, I never knew or understood why poeple complain. Now I am at the head of the pack!! Please search (Dogpile) and read some of the stories on there about Magellan...it is really sad.
If they referred here, what makes them think they don't have to pay?
I agree, Sue. Getting a verbal promise from your daughter was ridiculous. If you did everything they told you to do and went through the steps they instructed you to go through, it makes absolutely no sense that they are now denying payment. This seems to be pretty common with carriers who specialize, however. I know of one that almost every single time would deny claims, stating that it was a medical issue, not a behavioral medicine issue. If your daughter went in through ER, I can't understand why she was not seen by both the Emergency Medicine specialist and a psych resident or doctor. If Magellan tried to take over 'care' from the start, that is inexusable, especially in light of the fact that they now don't want to pay.
I work for a major HMO and the way most our member plans works is that for drug problems, the patient is usually first admitted for detox (ranging from as little as three days up to ten, depending on the severity and duration of the drug use), then goes for 30-60 days inpatient rehab with only 10-20% copayments (depending on their plan) and then six months to one year outpatient at the same copayment level.
Sounds to me as if there needs to be some serious reform in Washington state if they can get away with this.
Keep up the fight and I wish you the best.
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