Questions about EI Services - Really Frustrated

Background:

Jordan qualified for PT and OT through EI in Florida. We put it on hold for the summer because we're up in NY. We already used the PT benefits he had through insurance because while we were waiting for the long process and to see if he even qualified, we did private PT with him.

What's going on now is that the service coordinator is telling me that the provider we want must be on our insurance, even though he doesn't have anymore insurance benefits, because they have to get a denial before they can bill through EI. Fine. So, they are telling us that the provider we want does not take our insurance and that any of the providers who take our insurance do not have PT availability except for one hospital setting that we DON'T want. So, I'm trying to understand why it matters if the place takes our insurance or not, since insurance is NOT paying for it and EI is. No one has availability except this one hosp. setting and she's trying to tell me that it's my only choice then because they ARE providing me with the service, I just don't want it with the specific provider.

Is this how it works in NY???? It makes no sense. It is NOT going through insurance - who CARES if the provider takes my insurance. The woman is calling me back with her supervisor but I am getting nowhere and I don't want Jordan at a provider that I don't agree with just because that's the only one that's available.

Message edited 8/2/2010 2:31:00 PM.

Re: Questions about EI Services - Really Frustrated

how do they know you have insurance

Re: Questions about EI Services - Really Frustrated

When we were approved for services, I had to fill out paperwork that listed my health insurance information. They bill my insurance for services, and EI covers the rest. If my insurance didn't cover it, EI would pay for all of it. End of story. Insurance did not factor into my choice of providers, and we have more than one.

Re: Questions about EI Services - Really Frustrated

In NY you can either go through your insurance as a medical issue or you can go through EI. Most insurances do not pay for services through EI. EI will try though to do a claim. Our insurance rejected it. EI therapists never ask us for insurance since EI pays for it. EI is paying the therapists. Not our insurance. So it does not matter whether we have insurance or not.

Re: Questions about EI Services - Really Frustrated

That sounds like BS. They just want to see if your insurance will pay first, so they want you to stay with someone who is on your plan, thats what it sounds like. Tell them you don't have insurance anymore. When DD had PT, we had to give them our insurance info, and they billed for every session, but since my insurance didn't cover PT all claims were denied and EI paid. They can submit claims to whomever you choose,whether they pay or deny is up to your insurance. I don't think they have a say in who you choose. They don't up here. I don't know Florida rules, but it sounds fishy.