Yesterday, I explained how to get claims paid after a Prop falls on you.
However, some Rugby injuries required months of physical therapy to heal and get back on the pitch. How does your health insurance company handle those claims?
My guess: Poorly.
You'll have in your EOB (Explanation of Benefits) a limited number of PT visits. Use 'em. And document each time you see the Physical Therapist. Further, get the PT office involved your case. They have a vested interest in your health, because, simply, they'd like to get paid for what they do to you. The PT office will have a claims manager, who probably knows more about what each insurance company is willing to pay than I do! Together, you can work out a strategy to get the PT you need, and the money they need.
Don't shirk bills. Communicate with both the PT office and the insurance company. Remember, once something goes to collections, you're hosed. It's a pain, but keep every piece of paper organized in file, and create a communications log. A pain? Yep? A $1,000 bill because you forgot to send in paperwork? A much larger pain.
Now, two products could help relieve the burden of a lengthy recovery:
HSA(Health Savings Account): If this has been funded, they you've got pre-tax dollars to help you through the PT. Pre-tax money is like having the Feds subsidize your PT up to your tax bracket. If you haven't funded your HSA, but have a plan that's HSA-qualified, then you can list your out of pocket expense up to that year's HSA limits ($3050 per individual for 2010).
Accident Medical Cover: Remember, these plans reimburse YOU for stuff the insurance company doesn't pay for, as long as it's directly related to the accident or injury (up to the limit your purchase). This INCLUDES PT after the Prop falls on you. If you don't have a few thousand laying around, or have a funded HSA, then this plan is a no-brainer in season.
Claims...they suck. Just like a Prop falling on you...