Episode 3: Health Insurance and Residential Treatment - With Guest Scott Leshin
Updated: Nov 11, 2019
The question, "Why won't health insurance cover residential treatment?" is a question many families are asking, and getting no answer for.
Scott Leshin, Founder and CEO of SJ Health Insurance Advocates, has experienced firsthand the exhausting process of fighting health insurance denials. It was out of his own personal experience that he started SJ Health Insurance Advocates, where every day he and his staff help dozens of families doggedly pursue reimbursement for life-saving treatment; care that health insurance companies do not deem medically necessary. And why is that? Virgil delves into this question, and more, and tries to unpack a seemingly simple question made very complex by a constantly shifting healthcare landscape.
Scott Leshin comes to his current work from a very personal experience: he founded his company, SJHealth Advocates, after discovering firsthand how broken the health insurance industry is while trying to seek reimbursement for his son, Sam, who has cerebral palsy.
Scott received his Bachelor’s degree from Syracuse University and Master’s degree from NYU Stern School of Business. Prior to founding SJHIA, Scott worked on Wall Street for both Morgan Stanley and Goldman Sachs.
While working an intense full-time job, Scott was also managing the challenges and frustrations that came from navigating the health insurance bureaucracy. Through consistent and determined advocacy for his son, Scott continued to cultivate his knowledge and expertise of the health insurance industry.
After achieving success for his son (who he still fights for daily) and becoming aware that many other families also needed help, Scott launched SJHealth which now has 40 employees helping him to help families and mental health care providers nationwide to gain greater access to medical insurance resources for treatment beyond acute hospital care.
FRAMING THE ISSUE: WHY HEALTH INSURANCE COMPANIES ARE SO RELUCTANT TO COVER RESIDENTIAL TREATMENT.
HOW CAN FAMILIES BE SMART CONSUMERS, AVOID PITFALLS, AND GET THE MOST OUT OF THEIR INSURANCE?
BREAKING NEWS: CALIFORNIA JUDGE RULES AGAINST UNITED HEALTH GROUP FOR DISCRIMINATORY PRACTICES