Therapeutic Visits Reduced by a Third: Insurance not to Blame!
Someone has some ‘splaining to do. Let me fill you in…
Yesterday afternoon I received a text message from one of the Therapist indicating that insurance only approved two visits per week per discipline. This is a reduction from three sessions in the past.
Naturally, my fury was immediately directed at insurance. I told Sue and she was, ah, well… pissed. She even scared me. It’s just a bad idea to mess with a loving mom. I had a brief second of pity for the poor soul that was just minutes away from dealing with her. Being a frequent tenant in the proverbial dog house, I knew this was not going to be pretty.
She was on the phone with insurance within minutes.
Insurance tells Sue they approved exactly what was asked for. What’s that, you say? Are they telling her that the Therapists actually requested fewer visits?!? WTF… as the youngsters would say.
Sue calls me… so angry she has trouble forming a sentence. I know better than to mess with her in this state. Best to wait until she can muster at least noun-verb agreement. Amazingly, she has no problems with adjectives. I wait patiently as she somehow turns verbs into pronouns.
She’s just so angry that it’s my turn to have the baton handed to me. I’m off and running, placing a call to the senior therapist. Voice mail! I leave my best “can you tell just how angry I am?” message, asking for an explanation.
I hear back from therapist later that evening. Yep, it was her that put in for only two visits. Seems this was her plan all along, although she was quick to share the blame with the therapists who actually do the visit. I do my best to apply logic to her rationale. Sue does as well. Neither of us are able to connect the dots. Her babble is so counter-intuitive that I have no way of encoding it into my own mind. I continue to grapple with it.
Hers my problem, there was deception and cover-up. She withheld information and was hoping insurance would cover her tracks. When this didn’t happen, she remained silent… until I called. She has no idea (or, at least, no sympathy) for the damage she caused with insurance approving therapy going-forward.
This is outrageous and beyond comprehension… what could possibly be their reasoning? We know that you and Sue will use your justified anger to fight for everything that Ryan needs, especially since the insurance company already approved the amount of therapy he should continue receiving. No one on Team Diviney is giving up on Ryan and we are here to help support you in any way. We will be lifting up this latest obstacle in prayer for a quick resolution. Keeping the faith always <3
Is this a private therapy agency? Seems like the community needs to know who they are so they do not use them and get screwed like you did. On the other hand if this is a state agency I think Team Diviney needs to get on this as a letter writing campaign and send letters to the local government representatives for the state of Virginia or the governor so they know what the state employees are doing and how they are spending your tax dollars!
Jo Hobbs says
Yes, let us open that can of worms, “how they are spending your tax dollars!”
Case in point: D. C. government, but did you hear Marion Barry pronounce that there ain’t no corruption there!! Hahaha, and more!!
I take it this is your first time dealing with Medicaid. It is a nightmare–I am from New York State–the liberal Medicare state until Cuomo.My Mom had to have follow up physical therapy after knew replacement therapy. Was supposed to get four additional weeks three times a week. She received three visits showing her what to do with common household items and a length of robe. Three visits a week were reduced to two the first week, once the second week and ended. She was 87. A friend of the family came in and did the rest for free. It was a nightmare.
Jo Hobbs says
Will, those of us who have/had aging parents can relate! Medicare is a nightmare at times as well, and now physicians, especially specialists, are not taking Medicare patients, especially new ones!
This is so awful, could it possilby be an aprils fools joke? You can only hope. Still check this blog daily and think of Ryan often.
Oh no she didn’t!!!!!! Tsk tsk tsk, not only does she have some explaining to do, she needs to be held accountable for her unethical and unprofessional actions. No blame shifting, fact spinning or game playing. She needs to tell the truth. What was her basis, specifically, for making such a decision? What is the reason she would make such a monumental (and potentially very damaging) decision without even dicussing this with you in advance? Get your notebook out if you haven’t already, insist on a complete explanation, and ask them how they are going to remedy this (unacceptable) situation. Only the IBRF doctors are qualified to make any accurate assessment about Ryan’s cognitive progress. Shame on this home health agency for interfering with his treatment program in this way!! Ryan is entering into an extremely important phase of his recovery, and this agency has seen fit to willfully and deceitfully interfere with it. I hope you will update us as soon as you are able so we can provide support if you need it. I’m disgusted with this firm. How dare they take such a drastic measure without at least informing you in advance. Due to their negligent behavior, they have created added stress and inconvenience for you, Sue, and Ryan, and they need to fix this problem asap. Not only am I upset about Ryan being denied proper care, I am furious that you and Sue have had to experience this awful stress. You guys don’t deserve this at all, and I’m very sorry this happened to you. I have my pen in my hand, and I’ll be waiting…………..Lord, please give us all strength to deal with people who lack genuine compassion and integrity. And bless the Diviney family with an extra measure of Your grace and comfort…and, please protect Ryan from anyone who truly does not care about his best interests. Amen.
Evelyn Boxley says
OMG, I want you all on my team. Remember that doctor’s lesson well…………………..maybe he should talk to the therapist and let them in on how things are done!