[Brokenfriend]

I received a letter of denial that my last 60 minute Psychotherapy was not going to be paid for from my medicare/Medicaid insurance policy. I received this letter on Friday afternoon, and read it Friday night. I'm frightened about this. I have to wait till Monday morning until I can get in touch with the system. My case manager quit about a month ago, and I'm going to have to talk to somebody else to appeal this action. BF

[Brokenfriend]

It was a notice of Denial of Payment. I don't understand. This really shakes me up, and I'm very worried about it. BF

[Mari]

That really stinks.


Try to keep hope until Monday when you call to find out what is going on.


Maybe they made a mistake.


M

[mymorgy]

it sounds like some kind of mix up

[OhKay]

BF, my guess is that for some reason, they did not receive a referral prior to the appointment. You should also contact whoever is in charge of getting referrals for you to find out if they submitted one for that appointment or if you had enough referrals prior to that appointment.

I'm sure everything will work out

[Brokenfriend]

Originally Posted by OhKay

BF, my guess is that for some reason, they did not receive a referral prior to the appointment. You should also contact whoever is in charge of getting referrals for you to find out if they submitted one for that appointment or if you had enough referrals prior to that appointment.

I'm sure everything will work out

Thank you Kay. I went to a group therapy meeting a couple of weeks ago. My Nurse Practitioner, and my councilor were happy about that. My councilor was holding the meeting in her office. I wonder if there was a mix up about that with the insurance people.

The insurance people specifically said, "Psychotherapy, 60 minutes with patient and/or family member". There were no dates, just code numbers. It's impossible for me to know what they meant at this time.

You all probably know how I reacted to this letter. I felt panic, fear, and discouragement when I read this. I read that part over, and over trying to understand what they were saying. This is the first "Notice of Denial of Payment" that I've received. It's just not fair, and especially when I don't have a case manager at this time. They are looking to hire another case manager, but as of yet, they have not found one. BF

[Mari]

BF,

I hope things get worked out in your favor.


M

[Brokenfriend]

Thank you Mari. I'm going to be making telephone calls tomorrow morning. I've had this burden all weekend. I've already made some phone calls, and left messages.

If the letter came on Monday through Thursday, it would have been easier on me. (((But))) It came on Friday night, when all of the offices are closed until Monday morning. BF

[Mari]

Weekends and holidays can be hard on folks with anxiety.

I hope that Monday you can get some assistance.


M

[OhKay]

I would have felt the same way BF, especially if I got something like that late on a Friday

I get very anxious about things like that. I know you have left messages. I wouldn't leave anymore, but I would keep calling until you get living people. That's the only way you are going to get answers, get the matter resolved, and get some relief from your anxiety

These types of things can look scary, but it's probably not the final verdict. Call the insurance company and ask what the code means. The pdoc or therapist who provided the service and whoever requests referrals for you (PCP's office staff?) should be helpful in getting things straightened out for you