I received a letter today regarding my appeal to receive PT for a second major shoulder replacement. The letter stated Anthem does doubt I need the PT but I used the allotted (2) visits on my left major shoulder replacement so I was not covered for PT on my major right shoulder replacement.
It took approx (9) weeks for Anthem to determine it's final decision. The decision was based on the text in one sentence in my benefit coverage manual. Really?
It took (9) weeks for them to simply say read your coverage. To say I'm pissed is an understatement.
Product or Service Mentioned: Anthem Blue Cross And Blue Shield Medical Claim.
Reason of review: Declined coverage.
Monetary Loss: $2000.
Preferred solution: Provide benefits.
I didn't like: Decision and timing.