u/Full-Advertising-213

Hoping this post meets subreddit rules.

As a patient advocate, my top goal is to achieve is help people navigate through the insurance landscape and get reimbursed at higher rates for out of network therapists and other behavioral health providers. 🙏

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Hi community! 👋

I am currently researching behavioral health barriers in regards to insurance companies and how they authorize benefits.

I am hoping to speak with anyone who has experience in behavioral health utilization management (think single case agreement, gap exception, etc.).

My goal is simply to better understand how these processes work internally and where patients/providers commonly get stuck, so I can support people more effectively.

If this sounds like you or someone you know, feel free to DM me and we'll take it from there.

I recently started an independent patient advocacy practice focused on helping individuals navigate behavioral health insurance barriers, including prior authorizations, coverage approvals, single case agreements (SCAs), network adequacy gaps, and reimbursement challenges.

I have a lot to learn and am hoping to speak with anyone who has experience in areas such as:

• Behavioral health utilization management
• Appeals & grievances review
• Medical necessity determinations
• Behavioral health operations at insurance companies
• Provider relations or network management
• Case management / care advocacy within payers

My goal is simply to better understand how these processes work internally and where patients/providers commonly get stuck, so I can support people more effectively.

As a small thank-you for a 20–30 minute conversation, I’m happy to offer a $15 Amazon gift card. Conversations can remain anonymous if preferred.

If this sounds like you - or you know someone who may be open to chatting - I’d be incredibly grateful for a DM.