Insurance Problems for PT/OT

[admin]

I have a question. The women who runs my daughter's therapy practices. Is having a hard time with insurance delaying "denials" for payment, therefore when she tries to collect from Medicare they say the claim is too old and won't pay. She also is trying to come up with a way that she wouldn't have to turn away children because of lack of funds. She genuninely loves the children and working with them, she has a great staff too. She is getting in a situation where she is having to get more focused on the "administrative" side. I heard a woman when I was there talking with another woman, on how she hadn't seen her in a while, and it was because of medicare. It broke my heart. That is when I started talking to her about this. This is just a sampling. Also, our situation, is they aren't on my husband insurance, so we have to pay until we meet the max. out of pocket for an "out of network" practice. Thanks for any info.

Take care.

[Bridget]

This is certainly a common problem for most of us. And I think that the way the insurance industry is headed, things will just continue to get worse. For instance, my son's insurance just changed his coverage again, reducing the number of allowed therapy visits per year to 20. At one time we were allowed 60 visits per year, so we are really feeling this. Our response has been to cut back on therapy so that we can stretch it out over the year, which doesn't make me very happy.

Insurance issues are a big problem for our community as a whole in general (and for the rest of the U.S. as well, I think)...

Good luck,

Bridget

[admin]

I've run into the same issue before. My mother does medical billing and actually gave me advice to forward to our billing office. Have both the primary and secondary insurance billed at the same time. The secondary (medicare) then allows a longer period of time for the information to come in after is rejects the first submit- I believe this adds something like 90 days to the billing process- worth the shot at least!