Thursday, January 10, 2008

Not Medically Necessary??


Insurance! Yesterday I was very mildly hopeful for a bright start to 2008. The brightness has dimmed and has all but gone out. Someone with my insurance, in their infinite wisdom, has decided to state that all claims beyond 10/24/07 for Peyton's physical and occupational therapy are deemed to be NOT medically necessary and have been denied! NOT necessary. Do I need to take Peyton to that person myself to show them how ridiculous that is?? Now, that's 3 visits a week since that time that have been denied. They should have be covered at 100% at that point in our medical year. Haven't paid anything yet. This is about to get interesting as once the therapy provider gets wind of the denial, they'll be looking for their money even though, in the meantime, I'll be fighting tooth and nail to make sure we have a successful appeal.
So, at what point does one hire an attorney to fight on their behalf? Of course, that would probably cost more than the claims!
I'm thinking the men in the white coats are not too far away from me right now!! Just another day in the life, I suppose. But seriously, if you are praying people, could you please keep a prayer in your minds for a successful appeal? If we're not successful, this is going to have a serious impact in our ability to bring Peyton to therapy at all as it is quite expensive.
As always, we appreciate your support during our difficult and trying times. This is just the latest of many, but much harder to bear this time.

No comments:

Post a Comment

We welcome your comments and especially your prayers and support as our family journeys through the ups and downs of life with a special needs and medically fragile child. Thank you for visiting!