Insurance denied speech therapy as educational, not medically necessary. My daughter has a referral and a clear delay. Has anyone appealed this kind of denial successfully?
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Appeal it. Start with the denial letter, the plan criteria, the speech evaluation, and a letter of medical necessity from the referring clinician. The strongest appeals answer the insurer point by point: why therapy is medically necessary, what diagnosis or delay supports it, what goals will be treated, and why school services are not a substitute. File before the deadline, keep call logs, and ask about external review if the internal appeal fails.
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