After her husband L was hospitalized for a severe mental health crisis, Teressa barely had a moment to breathe before the health insurance denials started coming in, burying their family in medical debt.

But Teressa’s a fighter, and an organized one at that — ready to endure months of back and forth until she stumbled on a "secret door" to reversing her husband’s insurance denials: the external review.

In this episode of Paper Trail, a podcast from the investigative journalists at ProPublica, health care reporter Duaa Eldeib and host Jessica Lussenhop follow Teressa's journey to discovering this powerful and little-known tool — and putting it to work.

Could an external review help you? Check out ProPublica’s write-up, which includes the types of denials eligible for this kind of appeal.

And for more stories about appealing health insurance denials, you can check out our Starter Pack, which features episodes like this one about writing a killer appeal letter.

Here's a transcript of this episode.

Want weekly updates from the team, including some of our most practical advice for dealing with the outrageous cost of health care? Sign up for our newsletter, First Aid Kit.

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

See omnystudio.com/listener for privacy information.

While we’re busy working on some big projects this summer, we’re re-releasing some of our most ambitious and useful reporting to date.

Last year, we set out on a mission: Collect all the best advice about what to do when your prescription drugs cost more than you can afford.

Our listeners wrote to us about their experiences getting around this most demoralizing — and distinctly American — problem in order to get the medicine they need.

Those responses allowed us to map a whole landscape of potential fixes — none a guaranteed solution for everyone, every time — but all worth knowing about.

In this episode, you’ll meet some of the intrepid navigators charting the path — including a dad on a mission to afford his daughter’s epilepsy medication, a Medicare coach who helps seniors save tens of thousands of dollars on meds, a pharmaceutical sales rep with a brilliant short-term fix, and other generous and smart fellow travelers.

We documented all their advice and more in our Prescription Drug Playbook.

Here’s a transcript of this episode.

Want weekly updates from the Arm and a Leg team, including more practical advice for dealing with the outrageous cost of health care? Sign up for our newsletter, First Aid Kit.

Send your stories and questions! Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

See omnystudio.com/listener for privacy information.

One place you might assume is safe from prying ears is your therapy session.

But as more therapists struggle to negotiate with insurers, they’re turning to tech middlemen like BetterHelp and Headway that promise to take care of the insurance admin and match them with patients.

And these companies are sometimes recording and transcribing your sessions — and then turning around and sharing that data with social media companies and investors. And there are concerns that these confidential discussions could be used to train the next generation of chatbot therapists.

So this week, we’re bringing you an episode from our pals at Organized Money, a show about corporate consolidation and monopolies, where they speak with Linda Michaels, a psychologist and co-founder of the Psychotherapy Action Network, about the tech companies sneaking into your therapy sessions and how we got here.

And they share some good news: How one state, Illinois, passed a law in 2025 that could be a national model for encouraging more therapists to stay in-network, and ultimately, reduce reliance on these platforms.

For more on mental health coverage: Check out our episode about Abigail Burman, an attorney and expert on mental health “ghost networks” — lists of providers that turn out to be filled with inaccuracies, making it difficult for patients to get in-network care. Plus we have a whole guide from Burman on “ghostbusting” — AKA, getting your insurance to cover your mental health care. That’s in our First Aid Kit newsletter.

Here’s a transcript of this episode. We’ll be back with more Arm and a Leg in a few weeks.

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

See omnystudio.com/listener for privacy information.