Out of Network Appeal Tips and Tricks – BSCA – Help Please!

First thanks for even looking at this post. My partner had some complications pre/post pregnancy that required her to have bi-weekly physical therapy. This is the type of therapy that is both very specialized and where privacy would be required. We were told by the therapist that she would likely be considered out of network, however she indicated that others in the past have been able to appeal the out of network claim by stating there are no 'in-network' providers of this type of therapy within a certain number of miles from our home?

BS of CA denied the claim almost immediately, so Im asking if anyone has any expertise in this area as to the language and/or attachments I should include in my appeal that might just help push this over the edge. We can get doctors notes as it was 'prescribed' by her OB. I can do some research to show there aren't providers of this type of therapy (pelvic floor issues requiring a PT that is also a Women's Certified Specialist). Anyone know what else I should attach or state in the appeal form?

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Thank you so much in advance for any help here!

submitted by /u/punchyureself
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