Your Mental Health Coverage Was Denied. Federal Law Disagrees.
Therapy, inpatient care, ABA therapy, substance abuse treatment, eating disorder programs — insurers deny these at rates 3–5x higher than comparable physical health benefits. That is a federal violation.
⚖️ The Mental Health Parity and Addiction Equity Act (MHPAEA) requires equal coverage. We cite it in every appeal.
No account needed · Results in 15 seconds · Free to start
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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.
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
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.
88
Viability
Score
ABA Therapy · Autism
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.
85
Viability
Score
Inpatient & Substance Abuse
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.
82
Viability
Score
Here's How It Works — Three Simple Steps
From denial letter to appeal-ready in about 3 minutes. No legal experience required.
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📤
Upload Whatever You Received
Take a photo or upload a PDF — that's really all it takes.
Therapy denial, prior authorization rejection, ABA denial, inpatient coverage termination, substance abuse treatment denial — if it's official, confusing, and feels unfair, ClaimCompass can read it. Your document is handled securely and automatically deleted if you don't continue. No account needed to start.
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We Read It and Explain It
Within seconds — no legal jargon, no confusion, no guessing.
Our AI analyzes your denial, identifies whether a Mental Health Parity Act violation exists, and gives you a viability score from 0–100. You get a plain-English explanation of exactly what went wrong, whether federal law supports your appeal, and what documentation will strengthen your case. This analysis is completely free. No payment. No sign-up.
3
📨
Your Complete Appeal Letter Is Ready
Formally written, legally cited, ready to send — for $49.
ClaimCompass generates a complete appeal letter citing the Mental Health Parity and Addiction Equity Act, ASAM level-of-care criteria, your state's parity enforcement standards, and the specific error in your denial. Not a template — your case, your facts, your letter. Level 1 appeal, Level 2 escalation, and external review letters are all included. One payment. Every escalation level covered.
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.
90–100
Clear parity or legal violation — fighting back is very likely to work
70–89
Solid case — strong grounds for formal appeal
50–69
Possible — depends on documentation and plan specifics
95 /100
Appeal Viability Score
🟢 Parity violation found
95 /100
Viability Score
🟢 Fight back
Ready to Fight Back? Start Here — It's 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.
Free to analyze · $49 complete appeal · No subscription · All escalation levels included