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Discussion Starter · #1 ·
How do I start to fight our insurance company regarding paying for our son's OT? They covered it for three months and now say they won't cover anymore. I've never had to appeal a decision until now. His therapy center said they would give us all the necessary paperwork for the appeal. I just want to be prepared on my end. Any advice?
 

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We used to joke that I had a full time job, and fighting with the insurance company was my wife's full time job... and she "makes" (or saves) more money than me.

Submit it. Call and argue. Submit it again. repeat untill the bill stops shrinking.

We found that every time we submitted a claim, our portion of the bill shrunk. We decided to keep submitting till we got the same number back 2 times in a row.

I don't know specifics for OT, but this is how all of our medical claims have been in the past.
 

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Quote:

Originally Posted by ShaggyDaddy View Post
We used to joke that I had a full time job, and fighting with the insurance company was my wife's full time job... and she "makes" (or saves) more money than me.

Submit it. Call and argue. Submit it again. repeat untill the bill stops shrinking.

We found that every time we submitted a claim, our portion of the bill shrunk. We decided to keep submitting till we got the same number back 2 times in a row.

I don't know specifics for OT, but this is how all of our medical claims have been in the past.
agreed 100%
 

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Discussion Starter · #5 ·
I don't think so. My DH is going to call tomorrow and find out why we were denied. His company is small which could be bad (or maybe good). I don't know how much wiggle room there is in the policy.
 

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Probaly they suddenly decided they no longer cover a certain diagnosis. Find out, or have your provider find out, and then have them submit the claim with a diagnosis they'll cover. It's so absurd, isn't it?
 
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