beadreamerable
Denials and neglect - that’s all I get
This insurance is just a nightmare! For once I had rotator cuff and bicep surgery in November. In May I had meniscus surgery, but it failed. I struggle walking. As I started physical therapy, I received a notice of denial shortly after the end of the year 2022. It was not properly specified, and I had eight sessions for my leg and six sessions for my arm. After rotator cuff surgery you need physical therapy for 3 to 4 month minimum. I learnt later that the insurance made a mistake and thought I would not have coverage for them. Finally a letter dated January 4, 2023 reversed the denial. But I received the letter on January 17, 2023. It stated I was approved for the period December 7, 2022 through January 31, 2023. So that gave me 13 days left once I received the letter. I am now having three sessions until I run out of it. Yes, three sessions, which is pretty much useless. yesterday I received another notice, another denial. My previous physical therapy had applied for more physical therapy until March 30, 2023. The denial stated the findings don’t support the need for physical therapy. Further on in another section, it stated that it seems like a duplicate. Physical therapy does not reevaluate until you have at least 12 sessions. I never got them, because it was denied! I presume my old physical therapy send the original first evaluation again. They have nothing else, and I cannot make much improvement after six or eight patients. What do they expect! Since I changed the physical therapy place, they evaluated me Thursday and I hope they will get more therapy, but I have my doubt after all what I went through. We are also still fighting for another MRI for my foot. Now comes the best part! The doctor was trying to get injections for my knee, which is completely shot and I will need knee replacement, but we’re trying to delay it. The injections were denied - among the reasons/ suggestions : I should try PT therapy!!!! Well, give it to me - I want it so badly! While I have a lot of issues, so far I get denied pretty much everything - I am being neglected! I might be forced to apply for disability because of a miserable uncaring insurance!!!


