08-11-2016, 03:00 AM
The adjuster sends all Rfa to the ur department in hopes that they will get denied. In the beginning of my injury mainly the first 3yrs all Rfa were getting approved. Since it has been 8yrs since my injury they insurance no longer wants to pay for anything since they have paid so much.
Let's say I'm asking for a back support. When the reviewer at the ur department is viewing records from Doctor reports from
Doctor a
Doctor b
In the reports from a and b there is no supporting evidence to why I am in need of the back support. So it's denied however the insurance company did not summit Doctor c report that states that a mri was performed and the IW has 3 budged disc. With Doctor c records it could have got the item approved. What do you do then.
Also if you have a arm issue and the Doctor puts in for thearpy and the IC denies the body part then can you got to a qme?
Let's say I'm asking for a back support. When the reviewer at the ur department is viewing records from Doctor reports from
Doctor a
Doctor b
In the reports from a and b there is no supporting evidence to why I am in need of the back support. So it's denied however the insurance company did not summit Doctor c report that states that a mri was performed and the IW has 3 budged disc. With Doctor c records it could have got the item approved. What do you do then.
Also if you have a arm issue and the Doctor puts in for thearpy and the IC denies the body part then can you got to a qme?