Denied Weekly Sessions

[anonymous]

I have had troubles with an affiliate of UBH also, retained an attorney and lost the appeals. Now I have to settle. I can't disclose any info because I have to sign a non-disclosure form. That means no one will ever know how they rip people off in the worst way. They, and their affiliates are scum. How do they feel when they go home each night knowing that they screwed over another disabled person?

 

[bring em all in]

Anonymous- It's unconscionable that some people can screw people over like that!

 

[lostforgottensoul]

Sooo..my therapist sent the appeal a week ago and no one has heard from them so they are checking on it but he said if I want to self pay the other weeks he would cut it from $125 to $60. Which is what he did before. So not sure about that but at leaat I know its there if I need it. So we'll see. Thays still $120 a month so I dont know.

 

[bring em all in]

That gives you an option, albeit not a great one. Would one $60 session per month (meaning 3 sessions a month) be an option? Kind of a compromise until you get an answer?

 

[lostforgottensoul]

Would one $60 session per month (meaning 3 sessions a month) be an option?

I could. I guess it depends on the week. Hopefully the insur approves the appeal so i can go back to approved weekly.

 

[bring em all in]

Good luck!

 

[recoveringfromptsd]

Sometimes the only way around an anal insurance company approval process is to prove them wrong, they say you have improved, what happens if you have a meltdown over this. Maybe you meet the 1 week again. I went thru this same BS getting in to Sheppard Pratt, finally they drove to being suicidal and I drove to the ER next to pratt after being convinced to do so, which got me in to pratt, and they could not play the your too well game.

 

[lostforgottensoul]

what happens if you have a meltdown

I kinda did already. Was the first week without a session and got high and found something i shouldnt of and cut and punished and well yeah. So i dont know.

 

[Symphony]

To the original post: make it clear that your service dog is NOT working full time until he has been in training for 2 years. (even if some days he does work full time, he's still in training)

They probably think you have a brand new program dog fully trained and fresh.

 

[lostforgottensoul]

@Symphony, my insur doesn't know about my service dog in training. There is no reason for them to know. And they were talking about work. He doesn't go with me to work right now.

 

[recoveringfromptsd]

typical insurance BS, it would they are saying if you can work you don't need care.
I ran into the same BS getting into pratt, when I became highly suicidal and ended up in the ER next door they could not argue.

 

[lostforgottensoul]

Got the letter back about the appeal today and they state they need complete medical records before a decision is made and they need it by the 17th. Who the f*ck people are these? First, this is addressed to my therapist, he is the one going back and forth, I can't do anything. They won't even listen to me. But he told me that he told them my ENTIRE past, all of it. All of my diagnosis. He also said PTSD is on my records. All my issues. Everything in a very long thought out letter/appeal. Like what the f*ck? So you want 8 yrs of medical records for what again? My ACTUAL therapist says I need weekly vists. I'm on a downhill slide at the moment over this. AND you have my entire trauma history. What the f*ck else do you need?

Like OMG! I just want to scream! Yes, he said he will make those odd weeks $60 but thats $120 a month I must pay why? I don't get it. Someone please explain why this is so f*cking hard for them. Ok, they are "bean counters", so we have appealed, twice. I mean, I don't get it. I just don't.