MVC and Physical Therapy.

[Guest guest]

I tried to refer an active MVC patient, whose spinal

condition is slow in stabilizing, to a local PT who instructs in aquatic

rehab. This PT works well with DC’s but called today and Geico is

refusing the DC refer for Aquatic PT. Any insight? Can Geico do this?

Brad Rethwill DC

Eugene

[Guest guest]

Brad,

I've never heard of this on altho I've been denied for other treatment procedures. As the referring doctor, I'd call Geico and ask them for reasoning. Ask them who made the decision? A medical professional? IF so, could you please speak with that person in order to understand the medical justification for this. If a medical professional didn't deny it, who did? I've had other procedures denied based on a computer analysis, which we all know now is illegal. there was a precident for that someone posted earlier on a State Farm case I believe.

Another tactic is to have the patient ask their insurance agent to show them where in their policy it says they are denied certain types of PT. Ins agents are usually more responsive and helpful cause they sell the policies. If the ins agent can't find that, ask the agent to call the claims person who denied the PT and ask them to copy and send the exact portion of their policy that shows Aquatic PT is denied. Have the patient do this groundwork for you. Please let us know how it comes out. I've had these problems overturned by doing these two things.

Minga Guerrero DC

MVC and Physical Therapy.

I tried to refer an active MVC patient, whose spinal condition is slow in stabilizing, to a local PT who instructs in aquatic rehab. This PT works well with DC’s but called today and Geico is refusing the DC refer for Aquatic PT. Any insight? Can Geico do this?

Brad Rethwill DC

Eugene