Submit a Mental Health Parity Complaint in Georgia


Understanding Your Rights and Navigating Insurance Denials


Think Your Insurance Plan is Treating Mental Health Care Differently? Mental health and substance use treatment should generally be covered in a way that is comparable to other physical care. If your insurance company denied care, required extra barriers for treatment, or made it difficult to access behavioral health services, you may be able to:
  • Appeal the denial
  • Request an external review
  • File a mental health parity complaint
This page can help you understand what to do next.

Before You File a Complaint on Behalf of Yourself or Someone You’re Caring For

In many cases, it is important to first:
  • Save your denial and insurance documents.
  • Communicate with your insurer in writing.
  • File an appeal with your health plan.
Even if you plan to file a parity complaint, keeping detailed records and filing an appeal may strengthen your case. (For a more detailed step-by-step guide, see below)

Step 1: Organize Your Information


Before contacting your insurance company or filing a complaint, gather:
  • Your insurance ID card
  • Denial letters or Explanation of Benefits (EOBs)
  • Bills or invoices
  • Treatment recommendations
  • Letters from your provider
  • Notes about conversations with the insurer
  • Screenshots or copies of online messages and submissions
Keep copies of everything.

Step 2: Communicate in Writing Whenever Possible


If your insurance company denied mental health or substance use treatment, try to communicate in writing rather than relying only on phone calls. Written records are easier to track and may help if you later need:
  • An external review
  • A complaint investigation
  • Legal assistance
We recommend that you:
  • Submit appeals in writing
  • Upload documents through the insurer portal when possible
  • Save screenshots and confirmation numbers
  • Ask for decisions in writing
  • Keep a timeline of calls, emails, and letters
If you do speak with your insurer by phone:
  • Write down the date and time
  • Record the representative’s name
  • Save reference or call numbers
  • Send a written follow-up message summarizing the conversation
Consumers frequently report confusion and inconsistent information during appeals and external review processes, which makes documentation especially important.

Step 3: File an Appeal with Your Insurance Company


Many denials can be appealed. Your appeal may include:
  • The denial letter
  • A personal statement
  • Provider letters
  • Medical records
  • Evidence explaining why treatment is medically necessary
Ask your provider to explain:
  • Why the treatment is needed
  • Risks of delaying care
  • Why lower levels of care may not be appropriate
You can also ask your insurer for:
  • The medical necessity criteria used
  • Utilization review notes
  • Plan documents or Evidence of Coverage
  • Information related to parity protections
Federal law generally gives consumers the right to internal appeals and, in many situations, independent external review. For more information on health insurance complaints and appeals, please consult the Health Insurance Appeals Guide available from The Kennedy Forum and the National Alliance on Mental Illness (NAMI).

Step 4: File a Mental Health Parity Complaint


Which Agency Should You Contact?
If you have:
  • Employer-sponsored insurance
  • Individual or Marketplace insurance
  • Coverage purchased directly from an insurer
You can file a complaint with the Georgia Office of Commissioner of Insurance and Safety Fire. This agency investigates consumer complaints and suspected parity violations involving private insurers. If you have:
  • Medicaid
  • PeachCare for Kids®
  • Georgia Pathways to Coverage™
  • State Health Benefit Plan (SHBP) for state government employees
You can file a complaint with the Georgia Department of Community Health Mental Health Parity Complaint Portal.
Watch this video for a step-by-step guide on how to submit a complaint

Filing a Complaint Can Help

You can submit a complaint for yourself or on behalf of someone you care for. Filing a complaint may:
  • Help resolve your individual issue
  • Alert regulators to broader problems
  • Support enforcement of Georgia’s mental health parity laws
  • Help identify patterns affecting other consumers

Georgia law requires state agencies to track and report parity complaints and compliance concerns. While it may take some time to hear back after submitting a complaint, reporting your experience is still a critical step that can help identify patterns, improve oversight, and support others who may also be struggling to access needed care.

Important Reminder About Deadlines


Appeals and external review requests often have strict deadlines.

Do not wait for multiple phone calls or informal conversations before submitting an appeal or complaint. Even if you are still gathering records, it may be important to submit paperwork before the deadline expires.

Language Assistance and Accessibility


You may have the right to:
  • Interpreter services
  • Translated materials
  • Language assistance from your health plan
If English is not your preferred language, ask your insurer or state agency what language services are available.

You Are Not Alone


Navigating insurance denials can feel exhausting—especially when you or a loved one is already dealing with a mental health or substance use condition. Many consumers experience denials, delays, or barriers to behavioral health care. A denial does not necessarily mean the treatment is inappropriate or that you do not have options. Taking the next step—even a small one—can matter.

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