What is a gap in treatment and why does it hurt my case?
A gap is any meaningful period without treatment while you're claiming ongoing symptoms. Insurers look for them specifically.
The argument they support. If you were hurt, you'd have kept treating. A person who stopped for two months and resumed must have recovered, and whatever brought them back came from something else.
Why gaps actually happen. Money. No transportation. Work schedules. PIP exhausted. A provider with no availability. Family obligations. A period of feeling better followed by a return of symptoms. Every one of those is legitimate and none of them is what the gap looks like on paper.
How to prevent the harm. Keep treating if you have symptoms. If you must stop, tell your provider why and have it documented. A note reading "patient unable to continue therapy due to cost, symptoms ongoing" converts a gap into an explanation.
If a gap already exists, document the reason now and resume care. The gap stops growing when you're seen.
If you have to stop, tell your doctor why and make sure it's in the chart. ---
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