Physical therapy

[Dirtyhip]

Sorta frustrated at the process of getting a referral for PT.  I was told it is done via computerized method and it takes up to two weeks.  Meanwhile, you lose out on that time you can spend doing healing.  

Doing as much as I can at home and by googling, but there is only so much that a layperson knows.  

<frustrated>

[MickinMD ★]

I've had so much physical therapy from 2015 thru 2017 that I know the therapists kids, what sports they play etc.

My biggest headache was the total number of visits allowed.  Medicare supposedly requires a lot of paperwork to go past 30 visits - at least for my shoulder. But my supplementary BCBS says 100 visits for each therapy - I copied the section below, I have BlueChoice Triple Option (I can switch between HMO, Preferred Provider, and Out of State but BCBS approved providers) have levels 1, 2, and 3, and showed it to the head therapist. I told her it might mean I'd have a copay of $10 or $15 per visit, after $0 for the first 30, by switching to Level 2, and that was fine with me. She said, "Yeah, but they get goofy if Medicare says you don't need more than 30."

She is a very nice, real people-person and very sympathetic, but she wanted to reduce my visits from 3 to 2 per week to make sure I wouldn't go past 30 visits before my shoulder had recovered. I said something like, "No. I already contacted my employer's medical facilitator and she said 'You have up to 100.' I'll be damned if I'm going to worry about more than 30 when BCBS told me I could do 100 based on doctor or therapist's assessments. We'll do 3 per week and if BCBS cuts me off even though you say I need more than 30, I have the medical officer at my very, very large employer (36th largest school system in the USA) who will tell BCBS that it informed me I could get 100 visits, and 100 visits I will get if I need them. Trust me. I've been through similar things before with the BCBS bastards. They've tried screw me personally, but they back down when our medical facilitator, representing 20,000 customers, forces them to comply with their agreements."

I ended up with something like 37 visits and BCBS never had a problem with it and I was never charged a copay.

 

[Tizeye]

Quote

 

That is one area that the VA was very efficient. They told me they were making the referral and to expect a call from the PT Dept to schedule. Next day they called me and set up the initial appointment a week out. After the assessment, given home exercises with 2 week followup. Thankfully it is not a 2-3 day followup using their equipment like when I was in the service and actively receiving treatment at the time of my discharge. While local - and a very modern facility - it is a $4 toll each way, unless I take the far slower local roads which would include driving through the airport north to south entrance. Should be interesting when I show up tomorrow with the MRI results to see how it impacts treatment approach, as the VA was not aware I was getting it through a civilian Dr via Medicare.

[Randomguy]

What are you therapizing?

[Longjohn ★]

Never trust a therapist. Just break it down into the root words and you will see why. 

Root word “the” root word “rapist”

[Longjohn ★]

[bikeman564™]

On 4/18/2018 at 5:41 PM, Dirtyhip said:

I was told it is done via computerized method and it takes up to two weeks. 

 

this is BS IMO...I feel your frustration

[Razors Edge ★]

On 4/18/2018 at 5:41 PM, Dirtyhip said:

Sorta frustrated at the process of getting a referral for PT.  I was told it is done via computerized method and it takes up to two weeks.  Meanwhile, you lose out on that time you can spend doing healing.  

Doing as much as I can at home and by googling, but there is only so much that a layperson knows.  

<frustrated>

Well, you can always go with the "call a PT place, schedule an appointment, go to the appropriate sessions, pay with cash/CC, and then submit to insurance" route.

Tom