Appeals for counseling and therapy practices, built from your chart.

Appeals turn on the diagnosis, impairment, a treatment plan with measurable goals and notes that show each session's purpose and progress. Matches payer rules to the intake assessment, treatment plan and session notes, for licensed clinical social workers, professional counselors and marriage and family therapists.

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What the reviewer looks for.

These are the points a counseling and mental health therapy appeal has to prove. ClaimDoc checks each one against your record and names the page that proves it, or the document that is missing.

Intake assessment and diagnosis
An assessment documents the presenting problem, history and diagnosis.
Functional impairment
The record documents the impairment in daily functioning that treatment addresses.
Treatment plan with measurable goals
A treatment plan states measurable goals, the approach and the frequency and expected duration of care, and is reviewed over time.
Session notes for the denied dates
Notes for each denied date record the service, the time where it matters, the interventions and the client's response.
Symptom measures over timewhen it applies
Standardized scores recorded at intervals show the course of illness and response to treatment.

The records it asks for.

ClaimDoc asks only for what this denial needs, marks what you've uploaded, and says in a line why each one matters.

Intake or biopsychosocial assessmentneededEstablishes the diagnosis and the impairment treatment addresses.
Treatment plan and its reviewsneededShows measurable goals and why the frequency is needed.
Session notes for the denied datesneededShow the service, its time and the client's response.
Symptom scores (PHQ-9, GAD-7, PCL-5)Scores over time show severity and progress.

Denials it handles.

Plain words first. For each, what usually decides the appeal.

“Not medically necessary”
Diagnosis, impairment, measurable goals and documented progress.
“Visit limit reached”
Parity requirements and the plan's exception path.
“Provider type not covered”
The plan's credentialing rules for the clinician's license.

The rules ClaimDoc holds for counseling and mental health therapy.

Stored word for word

Medicare Benefit Policy Manual, Chapter 15, §170 (Clinical social worker services)

Medicare coverage on file

8 local and national coverage documents from CMS, across 4 Medicare contractors. When a Medicare denial rests on one, the letter names the one for your contractor and asks which provisions applied.

Payers, by how much is known

Cigna HealthcareTested end to end
Original Medicare (Part A outpatient and Part B)Policy text indexed
AetnaPolicy sources on file
Aetna Medicare AdvantagePolicy sources on file
Alignment HealthcarePolicy sources on file
Cigna Medicare AdvantagePolicy sources on file
Clover HealthPolicy sources on file
Devoted HealthPolicy sources on file
HumanaPolicy sources on file
Optum Behavioral HealthPolicy sources on file
SCAN Health PlanPolicy sources on file

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Tested, not promised.

Each of these ran from upload to a finished, verified packet on synthetic records, and every factual sentence traced to a page of the record or a stored policy.

Cigna HealthcarePsychotherapy appealed on Cigna's form, with progress shown by symptom scores; 19 of 19 sentences sourced2026-11-12

Fictional patients and clinics. A passing run shows the system behaved correctly on that kind of case, not that a payer will overturn a denial.

Send back proof.

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