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Kids With Special Needs and Disabilities
Reply to "Therapy coverage appeal "
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[quote=Anonymous]Can you clarify on what grounds you are appealing? Do you have OON benefits but they are denying claims even after meeting the OON deductible? Or is it that there are no available in-network providers? If that’s the case, you can ask your insurer about a single case agreement to get coverage with an OON provider but some OON providers won’t be willing. DS sees an OON therapist because we didn’t like the in-network options so we pay out of pocket and submit for reimbursement. It’s expensive. We pay $250 but the allowable rate is only $115 so even though we’ve spent well over our deductible, we haven’t actually met the deductible and might not meet it by the end of the year which is frustrating.[/quote]
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