Probably did no good, but I feel better.

Discussion in 'The Watercooler' started by Shari, Apr 12, 2011.

  1. Shari

    Shari IsItFridayYet?

    My ins has a cap of 20 visits per incident for both physical therapy and occupational therapy. (don't do the math, FB friends, it won't add up). With a broken wrist and an all but severed foot, that's not much rehab.

    So, for the past month, I've been working with the doctor's office to try and request additional PT. The surgeon's nurse has been getting the run around and on Friday was told all decisions regarding appeals and requests for services are handled by my company's HR department and the insurance company refused to give her any contact information to send supporting documentation to them for the request/appeal. Tho my company is self-insured, it is serviced by a huge Ins company, and HR does not make ins decisions. But anyway, I called our HR lady and told her this.

    While telling me, repeatedly, that I was being given incorrect information by the insurance company, she also told me, repeatedly, that there's a 20 visit cap on coverage. I get it, lady, that's why I'm trying to request more and plan the appeal. Yet on and on she's been going for 3 days about the cap on services.

    I just sent her the xray of my foot lying beside my leg before they put things back together. I said I understand that there is a cap, but this is why I have to try. Please get me the contact information for a request for additional servics and appeals.

    I'm sure it will do no good, but I bet she doesn't lecture me about the max visits anymore. lol
  2. Wow! I've been gone a while, you must have been in a horrible accident?!?! I detest insurance companies and their darn rules. There has to be exceptions depending on the severity of the injury and how much therapy is needed. Errrrr! I am angry for you!

    Would love to see the HR's face when she sees the XRays!!!

    Hugs, Vickie
  3. AnnieO

    AnnieO Shooting from the Hip

    20-visit cap. Nice. And they expect you to get back to the way you were before???

    I detest insurance companies... They are a necessary evil.
  4. Shari

    Shari IsItFridayYet?

    The accident wasn't too horrible, but the injuries were, I guess. Getting all better tho!

    I'm with you on wishing I could see her face. I just hate being lectured about stuff like that. If I'm asking for it, there's probably a reason...I dont just live for going to PT! But I've seen other people's faces when they see these! lol If they're a bit morbid, like me, they go "cool". The other response I can't type here. lol