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abatie 06-17-2010 02:20 AM

Insurance Issues
We are looking to try to find a PM&R closer to home. We are also looking to change doctors because the person we are currently seeing is booked for appointments 6-9 months out. That would be fine when we are in a monitoring stage but when the clinic messes up and doesn't get her appointment scheduled when it was supposed to happen we will now be a year out from our last visit. The problem is that in doing research to find someone closer to home we have found the three PM&R physicians closest to home DO NOT work with children. The only one we can find in the state that works with kids is out of network. Our physical therapist says that after talking to other PTs in the state that work with children that this is the person that we need to see. Does anybody know-are we out of luck because there are doctors in network (either at the office out of state that we presently go to or the ones that don't work with children)? Any advice anyone has would be appreciated.

missy 06-17-2010 03:20 PM

If you haven't already, get in touch with Basia... she's our insurance expert. Perhaps she can help you.

Have you spoken to the insurance company yet? Also, have you called the specific offices of the physicians who don't work with children? Sometimes, they say they don't, but they do or will.


abatie 06-17-2010 09:05 PM

The insurance gives their standard "you have the choice to go to whomever you what but if they are out-of-network then you will pay the costs". The offices are either "strictly no children" or they have said that because they don't work with children that they are not a good choice for us. They will say that if our child was a teenager it would be different but as an infant they are not willing to take on the case. I guess if they say on their own that they are not a good choice in our case I guess I have to go with that. My husband and I have discussed it and we may just go the out-of-network route but the cost on this would be extremely high. The frustration is that we should be able to see someone that can meet her specific needs closer to home than nine hours away. I will try Basia and see if I can get it to work.

abatie 06-17-2010 09:11 PM

I still can't log on to the " an expert" to send Basia an e-mail.

missy 06-17-2010 11:37 PM

Go to and start a new account for that.


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