Reflex Sympathetic Dystrophy (RSD and CRPS) Reflex Sympathetic Dystrophy (Complex Regional Pain Syndromes Type I) and Causalgia (Complex Regional Pain Syndromes Type II)(RSD and CRPS)

 
 
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Old 06-27-2016, 09:14 PM #6
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Jomar Jomar is offline
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Jomar Jomar is offline
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Join Date: Aug 2006
Posts: 27,745
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Is your atty appealing or contesting that denial?

Is your claim accepted , but the denial is for future treatment/meds?
Or is the whole claim denied?

This California based info , but could apply in other states also-
Why can’t I get the medical care I need?
(Along with the denial will be a form to request review of that UR denial by another anonymous doctor. This layer of review is called “Independent Medical Review” or IMR.)
Why can't I get the medical care I need? - Law Offices of Robert S. Havens


There may be ways to still get the treatments and have the bills placed on hold pending approval after review..
That should be something to ask Atty about..
my RSI claim was in 2003, and I was able to keep getting PT, by using my pvt medical as the secondary ins, pending wc case close/settlement..etc...
My atty wrote a letter to the providers , and they held the billing until after my hearing date.. but states have differing laws and changes over time,..
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Last edited by Jomar; 06-27-2016 at 09:35 PM.
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