Additional PT visits denial appeal over the phone failed and now 30-day review process NY Essential Plan. Any way to speed it up?


I have been going to PT for neuropathy in several parts of my body from spine issues under the NY essential plan. I contacted my Physical Therapist office today as I received a letter denying my PT as not medically necessary. The PT office called and was told the insurance doesn't see the need for PT to assist me at this time though I have neuropathy and other pain that was improving. I tried contacting the NY insurance marketplace to change insurance but the start date I was given is October 1st which is longer than the appeal. I am in pain which causes difficulty sleeping and would like to go back to PT, but cannot afford out of pocket. I messaged my pcp to request a letter of medical necessity as my previous neurologist I haven't seen for almost 2 years and the new neurologist's earliest availability was the end of October when I scheduled in June.

BCBS in the past had denied a valid MRI in 2021 falsely claiming no authorization that was just resolved after 18 months by contacting DFS and Department of Health which forwarded to Attorney Generals office.

Any help would be sincerely appreciated. I don't know if this is the best flare but this seems the closest.

submitted by /u/Appointment_Witty