Friday, June 21, 2013

Fire coming out of my ears

I was checking my insurance claims this morning online and noticed that my RE's office submitted a claim yesterday for my ultrasound appointment from March 8th.

This was the infamous appointment where we were told there was no baby. That there was no hope. That it was over. But they were wrong. An OB found it just two hours later.

I have no idea why they waited so long to submit this claim. 

I just wrote a frustrated email to their billing person to cancel the claim ASAP and I'm going to make sure that neither I nor my insurance will be paying them for that day. Can you tell this is a bit of a sensitive topic for me?

And in other news....

We were so blessed earlier this year to learn that we have a $10k lifetime infertility benefit  after never having any coverage in the past. I definitely do not take that for granted. But to add insult to injury, I just learned that our insurance pre-authorization for our upcoming embryo transfer has been denied!!! I could cry. Their rationale is that I am not eligible because I haven't proven that I'm unable to achieve pregnancy after one year of unprotected sex. What in the world do they want as proof of that?!

And the other reason is that I am supposed to attempt three IUIs prior to attempting our FET.

We already tried IUI, and we all knew it wouldn't work even when we did it. I'm asking my RE to appeal immediately with whatever proof they can supply. More stress to add to my already maxed out self. And to add to my current emotional condition, I just learned that my sister in law is pregnant and my cousin gave birth yesterday. It's not like they do it to hurt us. I'm happy for them. But it hurts. I just want to crawl into a hole right now. Why does this have to be so hard for us and seemingly so easy for everyone else?

Cue tears of frustration.

24 comments:

  1. Oh Liz... I'm so sorry! I know how hard it can be dealing with insurance... mine has infertility coverage but no coverage for adopted embryos. So they would have covered 80% of us trying another IVF, which historically didn't work, but not with healthy adopted embryos. Smart, right?

    Just think about what is going right. You've got embryos almost to your clinic! That's huge! You've got an awesome relationship with the donor family and you'll get to transfer them soon.

    Prayers and Godspeed! I know it's tough to look at the bright side, but it's much easier from an outside perspective. Trust me, there were loads of times when I could only count my worries over my blessings!

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    1. Thanks so much for the kind words. There is a lot going right, no doubt!

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  2. This just stinks! I am so sorry, Liz. Praying that everything gets sorted out. And praying for you as you deal with all of this. (((HUGS)))

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  3. Oh gosh Liz! I am so sorry you're having a rough day. That's a lot to take in all at once! I know there is a time limit on how long dr's offices have to submit claims but cannot remember how long it is. Hopefully they were just auditing their files and noticed they hadn't submitted a claim and didn't realize the situation surrounding it. Also, FX your RE can win the appeal for coverage! I hope this day goes by quickly and you are able to have an enjoyable weekend. Huge hugs and prayers that all this smooths over soon!! -DP

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    1. Thanks for the kind words. It turns out you are right. It was submitted by accident.

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  4. ahhhh!! That is a lot of stress to deal with at once! I hope things work out for you soon... xo

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  5. OMG I really how that all gets figured out! How awful!

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  6. That's too much in one day. I'm so sorry! I hope your RE can give them whatever proof they need. HUGS!

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    1. I think it will work out eventually. Sounds like my RE is going to bat for me!

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  7. Hi from ICLW. Sorry they are being such a pain in the butt.

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  9. Hey from ICLW! So sorry you are having such a tough road. Battling insurance companies and billing departments is a nightmare! I have spent hours and hours on the phone with both! So frustrating! Hoping things work out and best of luck with your upcoming FET!

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    1. It's awful! :( I'm sorry you've been through similar. Thanks for the kind words.

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  10. So sorry. If infertility wasn't a big struggle in itself, insurance woes is such a sucker on it.

    Ugh, can you forgo the repeat IUIs... such a waste of hope.

    #17

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    1. Thanks. There's no way we are going to do IUIs. No way!

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  11. Hi form ICLW. So sorry to hear about all the bumps in the road. It will all be worth it in the end though. Sending positive healing and inspirational thoughts!

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    1. Thanks so much. I appreciate the kind words. :)

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  12. Ugh, this is just ridiculous with the insurance policy. I hope your clinic can help you give them proof enough that this is what's needed in your case. Such a hassle. And I truly hope that you will be the next in family / among friends with a pregnancy announcement. It always hurts to hear happy news from others.

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    1. I hope so too! Quite a hassle. Thanks so much, I hope we get to announce a viable pregnancy too....I'm getting used to the latest announcements but it's never easy. :(

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  13. Easy for the non-infertile world, but you are definitely not alone there. I don't know of a single infertile that's had it easy. I'm so sorry you are having to go through this. It really does suck. And is stupid. Why would insurance companies want to pay for that many IUI's that you know won't work? Rediculous. I admire you for battling/refusing to pay for that first u/s. you keep fighting, my dear, and hang in there. Hugs!

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