> One beef down, Two to go!!!
> Last week I arrived at PT and was met at the door with" Karen, your
> insurance
> will not pay for more visits as it intended. They reviewed your diagnosis
> and
> felt that therapy would NOT be of any further use, since recovery is
> unlikely.
> They felt any improvement was merely based on subjective opinion, not on
> fact."
Dear Karen:
It sounds like you have a HMO or the like for your insurance. I do not know
where you are located, but here in Texas, we can sue our HMO's. In some
states you cannot.
In any event, please do appeal their decision to limit your PT. Also, ask
whomever made the decision if they know anything about(or even know how to
spell) Transverse Myelitis, the recovery statistics and what benefits(besides
recovery) PT has on people that are affected with TM. Get the name of the
doctor-quack- that reviewed your file and records, see what he-she knows about
TM, and exactly what files and records he/she reviewed and ask what training,
education and experience he/she has regarding PT and TM.
I'm sorry, this kind of stuff gets me up on my soap box. Fight the insurance
company and even make your complaint to the State Insurance Board where you
live and your congressman/women for legislation to allow suit against HMO's if
it is not allowed in your state. People die because of their stupid and
arbitrary decisions.
I have to go outside of my approved list or providers to get the treatment I
need and have to pay thru the nose for it. My rehab center I go to is one of
the best in the nation, and it is not on the "approved list". The uro's and
neuro's there deal daily with SCI and are up-to-date with our different
dilemmas. When I got TM(or it got me) my HMO tried to kick me out of the
rehab hospt after two weeks. The doctors there wrote letters explaining the
need for continued rehab, and I got 60 days of in-hospt rehab.
Nuff said for now !!!!
Bob - trying to fade the heat here in Houston