Business Details
17 Years
experience
Advocates for Autism and Mental Health Insurance Coverage
Founded in 2009, our organization emerged from the shared struggles of parents seeking essential healthcare services for children with autism spectrum disorders. As a trusted nonprofit, we combine decades of public health expertise with firsthand advocacy experience to help families and providers navigate complex insurance systems. Our team includes seasoned professionals with backgrounds in policy analysis, healthcare law, and clinical practice, who have successfully recovered over $100,000 for individual families through strategic appeals.We maintain authoritative partnerships with national attorney networks and regulatory bodies while offering transparent, sliding-scale services that prioritize client needs. Our proven track record in insurance authorization, billing dispute resolution, and mental health parity compliance establishes us as a reliable resource for families and facilities nationwide.
Services
Insurance Appeals
Regulatory Intervention
Provider Support Services
Wilderness Program Advocacy
Billing Dispute Resolution
Details
- Year established: 2009
Highlights and features
- Established in 2009 with proven insurance advocacy expertise
- National network of contingency-based attorneys for complex cases
- Sliding scale fee structure for family accessibility
- Specialized knowledge of MHPAEA and state parity laws
- Successfully recovered $100,000+ for families through appeals
What people say
Proven results
Expert insurance knowledge
Compassionate support
Effective advocacy
Regulatory expertise
Services
Insurance Appeals
We specialize in filing insurance appeals for families seeking coverage for autism and mental health treatments. Our team handles both initial appeals and external reviews with state regulators, utilizing a national network of contingency-based attorneys when necessary. With expertise in MHPAEA regulations and state parity laws, we help families challenge denials for medically necessary services including residential treatment programs and intensive therapies.
Provider Support
We assist mental health facilities and wilderness programs with insurance authorization processes and billing disputes. Our services include pre-authorization, ongoing utilization review, and claims submission for providers. We manage insurance company communications and handle appeals when treatments are denied, allowing facilities to focus on patient care while ensuring compliance with regulatory requirements.
Regulatory Intervention
Our team intervenes with state regulatory bodies to address insurance coverage violations. We educate legislators on mental health parity laws and advocate for policy changes that benefit individuals with autism spectrum disorders. Through direct regulatory engagement and collaboration with advocacy groups, we challenge discriminatory insurance practices and promote expanded coverage for essential treatments.
People
Karen Fessel
Founder and Executive Director
Public health expert with UC Berkeley doctorate who established the organization after personal struggles securing services for her son with Asperger's. 20+ years experience in healthcare policy and insurance advocacy.
Lisa Valerio
Treasurer
Marketing professional with 20+ years experience, active volunteer in autism support groups, and former insurance advocate for Autism Health Insurance Project.
LaJoyce Porter
Director
Sole practitioner in Concord, CA specializing in education law with focus on special needs advocacy. Former insurance defense attorney with personal experience supporting children with special needs.
Questions
What insurance services do you help with?
We assist with appeals for denied claims, regulatory intervention for coverage disputes, and authorization processes for residential treatment programs and therapies.
Do you work with out-of-state clients?
Yes, we operate nationally and have experience navigating insurance systems across multiple states.
How are your services funded?
We offer sliding scale fees for families and charge hourly rates for facilities, with some services available on contingency basis.
Can you help with wilderness therapy coverage?
Yes, we have successfully advocated for wilderness program coverage and can assist with authorization and appeals processes.
What insurance types do you handle?
We work with private insurance plans, Medicaid/Medi-Cal, and non-federal government plans including self-funded arrangements.
