Everyone knows the old saying about death and taxes being the only certainties in life. Physical therapists (PTs) and physical therapist assistants (PTAs) can probably add 1 more to that list: appeals to insurance company payment decisions.
Here are a few tips and resources from APTA, to help you get it right.
Appeals are important …
Yes, the appeals process adds yet another administrative burden to your plate, but don’t forgo the process when you feel that medically necessary services have been denied or partially approved. You have a responsibility to protect the patient if payment for appropriate care is denied. And, remember, you won’t be able to pursue an appeal at a higher level—the insurance commissioner’s office—unless you have done your due diligence and exhausted all other means of reconsideration.