Reply to OT for hypotonia not covered by insurance?

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Reply to "OT for hypotonia not covered by insurance?"

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[quote=Anonymous]It also helps to get a letter from your doctor and/or developmental ped. that says the OT is "medically necessary."  I concur that you need to be very persistent.  Some things that worked...1.  Get a letter from your doctor and/or developmental ped. that says the OT is "medically necessary."  2.  Have the therapist even if you have to pay her/him to write a lengthy report about why your DC needs the therapy.  You cannot provide too much information in this instance.  The reports will be forwarded to peer review.  If they deny, keep sending information.  You want to keep the dialogue open so you don't have to appeal.  Once it goes to appeal, it's much more difficult to get the claims approved.  3.  Call daily (yes, it was a huge amount of time, but it was for thousands of dollars.  4.  Submit each claim/date of service (DOS) separately.  Eventually one may get processed.  Larger insurance companies such as Aetna don't approve all its claims manually.  Most are done by a computer.  One may be more helpful than the other.  3.  Once a claim gets processed, call customer service and have them link all other claims to that DOS.  Good luck!  We've had a number of insurance companies over the past five years, and I had to fight each of them for reimbursement.  Eventually, we were reimbursed.  Fortunately, we were in the position to float the costs until that happened.[/quote]

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