Physical Therapy Case Study

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This letter is in response to your appeal regarding physical therapy services provided October 26, 2017 through February 19, 2018. As a Grievance and Appeals Coordinator, I, along with a Medical Consultant, reviewed your claim, your appeal and your health care plan benefits for Blue Cross Blue Shield of Michigan (Blue Cross). After review, payment is approved.

As a result, your claims have been adjusted and payment will be forwarded to Vanderbilt University Medical Center. Physical therapy (PT) is a covered benefit by your group’s health care plan. In 2017 your group health care plan provided coverage for PT subject to your deductible and coinsurance requirements. I confirmed that you had met your deductible and out-of-pocket maximum requirements
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