Insurance clawing back PT right after I won a related appeal
In 2021, my insurance was United Healthcare. I developed a knee issue in the spring, went to the Dr who thought I needed an MRI. UHC, of course, denied it and required me to do PT. A few months of PT and no improvement, I got sent to a specialist, who then got UHC to approve a MRI. Based on that, I had no option other than knee surgery. Which was pre-approved, but once they went in what was wrong turned out to be very slightly different from what they had thought was wrong. So they had to bill with a different CPT code than had been approved…UHC denied it and almost a year later, I just successfully won the appeal and they’ve paid it. Now- a week after they agreed to pay for the knee surgery, they went back and un-approved 10 of the knee PT visits. This includes 3 visits before the MRI and then 7 that happened right after surgery.
The timing seems like it can’t be a coincidence – is this an insurance thing where if you successfully fight one thing then they will go try to deny something else that they already processed fine? Any suggestions? I am so sick of dealing with UHC and part of me wonders if they do this intentionally with the hope that people are tired from just finishing one fight and don’t fight the new denials.