Insurance online program vs in-person PT

I have a back injury (broken vertebrae) and the ortho recommended PT (referral was for 3 visits a week for 8 weeks). Insurance approved 10 visits. The facility I chose does a great job – combination of exercises and massage/muscle stimulation. I was making excellent progress.

After my 10 approved visits, PT requested additional visits. Anthem denied, saying it was not medically necessary (who the hell are they to determine?!?!). The denial clearly stated their criteria for additional visits and I meet all of them. I have no idea why I was denied. I have sent a written appeal. Who knows when/if they’ll get back to me…

In the meantime, I received an invitation from Anthem to participate in their Back and Joint Pain Program. Looking at the materials, it appears to be an online PT program – exercises and consultation.

For me, the in-person PT was helpful because of the combination of exercises with the hands-on massage/electric stimulation. Obviously the online program cannot offer the massage/stim – just exercises.

If I don’t participate, will this hurt my chances of winning my appeal? If I do participate, will it make it more likely that they’ll deny my request for extra in-person PT visits? I’m not sure how to proceed.

Thanks in advance for any guidance.

submitted by /u/RealisticBike4953
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