The letter you have
Therapy, inpatient care, ABA, substance use treatment — denied at rates far above comparable physical health care. That gap is often illegal.
At stake: $1,000 – $50,000+
Health & Medical
You found the right place.
Your Mental Health Claim Was Denied. Federal Law May Protect You.
What we do with it
We read the letter. We explain it in plain English. In about 30 seconds you’ll know where you stand — and what to do next.
No account needed · Results in about 30 seconds · Free to start
The Law Most Insurers Are Violating Right Now
The Mental Health Parity and Addiction Equity Act is a federal law that requires health insurers to cover mental health and substance use treatment the same way they cover physical health. If your plan covers unlimited physical therapy visits but caps therapy at 20 sessions — that is a parity violation. If your insurer requires prior authorization for every day of psychiatric care but not for cardiac care — that is a parity violation. These are among the strongest grounds for appeal in health insurance law.
What Does a High Viability Score Mean?
A score above 70 means you have a solid case worth pursuing. A score of 90 or higher — which we see frequently when a parity violation is present or the insurer's denial reason is directly contradicted by ASAM criteria — means the denial has a real legal error a reviewer must address.
90–100Clear parity or legal violation — fighting back is very likely to work
70–89Solid case — strong grounds for formal appeal
50–69Possible — depends on documentation and plan specifics
Three Common Mental Health Denials — and Why They Are Overturnable
These are the situations we see most often. Every one involves a clear legal argument you have the right to make.
Therapy & Outpatient Care
88
Viability
Your insurer denied therapy sessions — or requires prior authorization your physical health benefits don't require.
"This service exceeds the plan's mental health visit limitations and requires prior authorization for continued treatment."
Why it overturns: Under the MHPAEA, your insurer cannot apply stricter visit limits or prior authorization requirements to mental health services than to comparable physical health services. If your plan covers unlimited physical therapy without prior authorization, applying session caps or auth requirements to mental health therapy is a textbook parity violation. Request your plan's non-quantitative treatment limitation analysis — they are required to provide it. This single request often resolves denials before a formal appeal is filed.
ABA Therapy · Autism
85
Viability
Insurance denied ABA therapy for your child's autism spectrum disorder — or severely limits approved hours.
"Applied Behavior Analysis therapy has not been authorized as it does not meet the plan's medical necessity criteria for the requested number of hours."
Why it overturns: ABA therapy is recognized by the U.S. Surgeon General, the American Academy of Pediatrics, and every major medical authority as medically necessary for autism spectrum disorder. Most states have enacted ABA insurance mandates specifically because insurers attempted to classify it as "educational." Limiting ABA hours while covering comparable physical rehabilitation without the same restrictions is a direct parity violation. Courts and state insurance regulators have consistently ruled in favor of families appealing ABA denials.
Inpatient & Substance Abuse
82
Viability
Inpatient psychiatric care or residential substance abuse treatment was denied — or coverage was cut while the patient was still in treatment.
"Continued inpatient stay is not medically necessary. The patient may be treated at a lower level of care."
Why it overturns: The gold standard for substance use disorder level of care is the ASAM (American Society of Addiction Medicine) criteria — and it is frequently applied incorrectly by insurance reviewers. Concurrent review denials (cutting coverage while a patient is still in treatment) are among the most dangerous and most contestable. Your insurer's reviewer must demonstrate that a lower level of care is clinically appropriate — not just cheaper. Parity also requires that inpatient psychiatric criteria not be more restrictive than comparable inpatient medical criteria.
Here's How It Works — Three Simple Steps
From denial letter to appeal-ready in about 3 minutes. No legal experience required.
1
Upload Whatever You Received
Take a photo or upload a PDF — that's really all it takes.
2
We Read It and Explain It
Within seconds — no legal jargon, no confusion, no guessing.
3
Your Complete Appeal Letter Is Ready
Formally written, legally cited, ready to send — for $39.
How to appeal a mental health insurance denial — start free
Upload your mental health denial or notice. In under a minute, you'll know exactly where you stand — and whether federal parity law is on your side.
Start My Free Analysis →Free to analyze · $39 complete appeal · No subscription · All escalation levels included
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