PT (good) insurance (bad)
First, the good news:
I had my last session of physical therapy today ... 
! No more getting up at 8 a.m. and earlier and dragging myself to PT and being in pain for the rest of the day (although today, I was too pissed after I got home to worry about being in pain).
Which leads me to why:
Got home, was in a good mood after being discharged, plus, got my hair done and was looking mighty fine (cut, colored, highlighted ... much blonder than the last time ... we figured that the color must be older or something, because this has happened before). Brought in the mail and there was something from Blue Cross. Figured it was just a statement, so I made lunch, sat down to eat and checked it while I was eating. It made my stomach turn. BCBS has denied my appeal of their denial of service for my home physical therapy for the four weeks while I was homebound. They say I wasn't homebound and it wasn't medically necessary, and there were transporation resources available. My doc has already written one letter saying I was unable to drive for four weeks, meaning I was homebound, unable to travel, homebound, he wanted the home PT. They (BCBS) paid for the first two weeks, then denied the next two while I was having them. The first time around, for the first knee replacement (on the same knee), they called ahead of time and insisted I have home PT. The representative came in and introduced herself while I was in the hospital. What a difference two years make! And actually, you would think they would want home PT on a revision because there's more risk involved, more chance of infection and problems and patients need more aftercare and attention. Considering I could have been in a rehab hospital instead, I would think the home PT would have been much cheaper.
So I call BCBS to complain because it says you may have the right to appeal. And after complaining to the poor customer service rep, she says I have to go through my administrator. OK. So I make copies of the letter I got, go to work and am ready to plead my case. First I go to the first floor, where I think I need to go (our HR office recently moved). Wilma tells me to go see Sue, on the second floor, where they used to be. OK, so I go upstairs. I talk to Sue, who instead of being the advocate for me, is arguing the insurer's case (who is she supposed to help, anyway?). That gets me even angrier, but I hold my tongue as she sends me back to the first floor to talk to someone else. Jeff was very nice and tells me he'll see what he can do.
My ortho doc is already going to write a letter for me (the nurse said he would); I plan on calling the home PT place to see if the two therapists can write letters for me. I can surely have them attest I was homebound and unable to drive. There isn't a lot of transportation resources around here ... most would be cabs and cost a lot (which I don't have). My friends all work days and don't live near me to drive me to PT on a regular basis ... it's hard enough to get a ride to my pain treatments when I need a driver, and that's only every three months. I know I wouldn't have made the progress I had without the home PT (especially the man, *****ally pushed me); that got me ready for when I was able to drive to PT.
I sure don't want to be stuck with this big bill; it will about wipe out my HRA and my FSA, leaving me to pay my drug and doctor copays for the rest of the year, and that won't be fun at all. Or, the home PT place will get the $20 a month for not checking ahead of time.
Annette 
as to the insurance, keep appealing, put it in writing, have your doctor write for you again if need be. just keep after it. they will most likely give in eventually. just be sure you do your serious appealing by letter, ive had experience in the past with this, and they do not always track phone calls the way they should. also, it should have been the responsibility of the therapists to make sure they had approval for you, thats usually how it works with PT, so be sure to get them involved here also. and keep your chin up, this insurance stuff stinks!!!!!!
i wish you luck.
hugs, jacki
