Monday, July 15, 2013

Let's talk about some good things.

I have been posting mainly about embryo shipping delays and insurance bureaucratic nightmares that have been frustrating the crap out of me for going on months now. So instead of posting about the frustrating and obnoxious things today, I am going to write about what is going well.

Today, out of the blue, I got an email from my RE's billing person. She was letting me know that she had just learned of the insurance denial this morning. Even though she had no knowledge of the fact that I already knew of the denial and Kevin and I had already made the decision to pay out of pocket, her email proposed that instead of us paying the typical $4050, she would accept only $2733.65 out of pocket!  She is confident my insurance will pay monitoring and ultrasounds, which is the reason for the lesser amount. She will still submit the claims after the fact for the amount we will be paying out of pocket, I'm glad to hear we are on the same page without even asking. And $3k out of pocket is a lot easier to stomach than $4k we were previously expecting!

And on that same topic, I contacted my HR benefits rep last Thursday about the appeal denial. She was able to quickly get in touch with our assigned company-wide insurance rep. The insurance rep has already reached out to the medical review panel who denied the appeal and we are waiting to hear back any day now. There is still an unrealistic but hopeful part of me that thinks they may change their decision based on the rep's involvement, but who am I kidding? I told my HR Rep in no uncertain terms they have until Friday to make some progress on this otherwise we will pay out of pocket. And if my insurance company won't pay out the claims we submit after the fact, an attorney will be contacting them to collect reimbursement. That is not an empty threat.

But between me and you, if the embryos haven't even shipped by Friday there is no sense in me paying out of pocket right away to continue to wait for them to ship. My cycle will still be delayed until they get here so I might as well let my HR rep still hash it out with the insurance in the meantime. But in her mind, she has until Friday. I'm sure it won't make a difference but whatever.

And last, in non-infertility-related good news, I'm elated to tell you Nadia has made tons of measurable improvement in the very short amount of time since she was diagnosed with kitty diabetes on June 28th. She has already added 8 ounces back to her previously bony figure (which is a lot for a 10 pound cat in just two and a half weeks!) And her blood sugar went from being at 441 at the time of her diagnosis to now staying steady between 200-300. I am going to be slowly increasing her insulin dose this weekend but I have every reason to believe she will go into remission after a few months of her being regulated as her pancreas heals. Until remission, I am a slave to her blood glucose testing throughout the day and her twice-daily shots, but all of that hard work has been made much more rewarding now that I know it's working and she's getting better!

Thank for all of the prayers and support. I can feel good news just around the corner. And I have a feeling that once we get past these final two hurdles, everything is going to fly at supersonic speed after that!

11 comments:

  1. That's awesome the RE's office will accept less than the full amount! I hope those "hamburgers" get shipped soon!!

    Yay for Nadia's improvement! FX she is in remission soon.

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    1. Yeah, it's a blessing out of the blue! :)

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  2. I really hope you get the insurance stuff sorted out, and don't have to pay OOP! But at least if you do have to pay, it won't be as much. And those "hamburgers" better ship soon!

    Zeus & Hera are very happy to hear that their buddy Nadia is doing so much better! Get well soon! <3

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    1. Thanks so much. Can't wait for these hamburgers! Tell Zues and Hera Nadia says thank you!!

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  3. Wow that is such great news that they are asking for so much less out of pocket. Also great that the HR person is being more pro-active this time around.

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