My insurance company is being pr*cks and they only have given me 20 physical therapy sessions for the year. I had to use 5 pre-op which only left me with 15 post-op. It has been 5 weeks since my surgery and I only have 10 sessions left, I still have not gotten full ROM back yet and I’m worried that I won’t be able to recover in time when my sessions are done. My PT person said that he had never heard of an ACL tear being rehabbed that quickly. The sessions are $90/session and there is really no way of me being able to afford an extra $180/week. My surgeron prescribed 2-3 times/week for 12 weeks after surgery(I have of course only been going 1-2 times). and then 1-2 times/week for the next 12 weeks….what should I do? The insurance company said I could appeal the sessions(would have to go through the appeals process for each session), but I have to take the sessions first and then go through the appeals’ process. Of course if they decide to overrule the appeal, I would have to pay…
#1 by holly_pw on January 24, 2010 - 11:23 am
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What I do with my patients in that case is cut down their visits to once a week so that they can prolong the amount of time they can come. They can also go ahead and work with the insurance company and try to go ahead and get more approved so that you don’t. At our clinic if you come a few extra and don’t get approved, we just write it off and don’t make you pay, cause it’s not your fault. But to answer your question you NEED to be in therapy as long as possible
#2 by emily b on January 24, 2010 - 3:30 pm
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Be willing to actually do all of your home exercise programs.
Tell him that you are willing to be as independent as possible.
Go as little as possible. Maybe you can arrange it so that you only set up an appointment when you can do all the exercises he gave you with minimal pain.
The bottom line is that your PT is going to have to work with you to make this work, and you have to be willing to do some of the work on your own.
Good luck!
#3 by greengo on January 24, 2010 - 4:46 pm
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That is so typical.
they want to make sure the CEO gets the multi million dollar bonus!
If they will not approve, you might need to do more of your exercises on a home basis. I have stuff at home that I use, and also water walking (pool therapy) is really good, see if they can give you stuff that you can do at home and at your local pool.
Good luck, knee probs suck