Annecdotaly: I was recovering from hip surgery. Further PT denied even though I was still in pain and didn't recover 100%. I'm 35. Not 75. I expect to get back to hiking 10 miles.
But their denial lead to more pain, and an appeal takes at least 30 days.
There should be a law that says you are guaranteed continued treatment when your appeal is pending. That way they actually have the incentive to do it properly. Now whether that again is a close and deny... yea, not sure what the solution is there.
But their denial lead to more pain, and an appeal takes at least 30 days.
There should be a law that says you are guaranteed continued treatment when your appeal is pending. That way they actually have the incentive to do it properly. Now whether that again is a close and deny... yea, not sure what the solution is there.