Most common Psychiatry denials
Denials you probably recognize
Inpatient psychiatric admission denied -- outpatient level preferred
Residential treatment denied -- IOP/PHP not attempted
TMS therapy denied -- medication trials insufficient
Esketamine denied -- step therapy requirements
Neuropsychological testing denied
Sound familiar? WinTheP2P generates a structured response script for each of these scenarios in 60 seconds.
Psychiatry-specific P2P strategy
What wins psychiatry P2P calls
Reference APA practice guidelines and treatment algorithms
Document suicide risk assessment with specific risk factors and protective factors
For TMS/esketamine, list every medication trialed with doses, durations, and reasons for failure or intolerance
Cite functional impairment: GAF scores, PHQ-9/GAD-7 trends, work/social impact
Emphasize safety concerns that necessitate higher level of care
Key criteria sources
Guidelines that matter for Psychiatry
When speaking with a medical director during a P2P call, referencing the correct clinical criteria is what separates a successful appeal from a denied one. For psychiatry, the key sources are:
APA Practice Guidelines, ASAM Criteria (for SUD)
WinTheP2P automatically references these criteria when generating your psychiatry P2P prep scripts.