Empire only approves me for 6 PT visits at a time, even though I need 3 visits per week. This doesn't sound right at all but two representative told me this. This is affecting my recovery.Empire staff told me that AIM staff does the auth, implying that Empire has no control over auths.
My insurance company, Empire BCBS, is not authorizing my visits in a timely manner, which forces me to go several days to a week without a visit. My surgeon has prescribed physical therapy 3 times per week until I see him again on August 11, 2022.
Aim speciality health how to#
I am currently still in a brace and learning how to walk again. I had patellar realignment knee surgery on April 8, 2022. Although this has been a repeated experience of mine when dealing with this organization, the most recent example took place today 11/30/22 at approximately 8:45 am with ************************. Finally, during the peer to peer review there is often a lack of either knowledge or insight, and the sense that the primary goal is to deny coverage. There is typically an extended period during which I am kept on hold when waiting for the peer to peer review to take place. Although documentation supporting the need for requested procedures is submitted in advance of the peer to peer review, this is seemingly not reviewed in any meaningful way. Although they may allow for "peer to peer" review to be conducted between ordering health care providers and physicians on their staff, this process is time consuming and arduous, clearly creating further obstruction to coverage of necessary procedures. They repeatedly deny coverage even when there are clear indications based on accepted medical standards. AIM specialty health makes determinations regarding insurance coverage for sleep studies. I am a physician conveying a concern that interferes with care for many of my patients.
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