CD 1 ish

Man, I have had the worst week. All thanks to the insurance. I think we’ve cleared it all up but I was at the end of my tether today. Let me see, where did I leave off?

So awesome D at the insurance gave me his email and said he would help expedite my claim since it had been sitting with them untouched for 2 months. He wanted me to send him and itemized receipt from the PGD lab with the procedure codes and the diagnosis codes.

Easy, right? Sent and email to the lab after calling them and was sent the itemized bill that day which was awesome. I sent it over to D with a big smile on my face. The next day I get an email from him saying that that bill had the procedure codes but not the diagnosis codes. he needs one with both.

Back to the lab again but they tell me that I need to get a letter of medical necessity from my clinic with the diagnosis codes. They don’t do that. Okay fine, email my clinic for the letter. She said she’d sent it right over. Yay! I asked if she could email me one if it would be quicker. Sure she sent it right over. Whoo… no, this letter is neither on a letterhead nor is it signed. Email back to point this out. No problem, they’ll have him sign it and snail mail it to me (Can medical places get new technology please? Why are we still faxing and snail mailing when there are scanners about?). Two days later I get the letters… Two letters. One on a letterhead but not signed and the other signed but no letterhead. *breathe*

I decide to send the letter head one to D as it looked more professional. No reply that day. The next day (yesterday) I emailed again to see if he got it, then I called as well to see what was up. The guy on the phone, though very apologetic, couldn’t help me. He just saw that the claim was pending. At 7pm D replies (very curtly I might add) that the letter I sent didn’t have the diagnosis codes and that I should get an itemized bill from the lab with both the diagnosis codes and the procedure codes.

I’m convinced I had a tiny aneurysm and my whole body just deflated. The diagnosis codes were clear as day on that letter. I don’t know if he wanted them labeled “here are the diagnosis codes”. I don’t know if those were the right codes. I was under the impression that the doctors write these things all the time, why would they mess it up? Who was wrong here? What the hell was going on?

My reply to him was less than professional but I managed to keep the swears out of it. I was so out of sorts and depressed after reading his email that I silently cried myself to sleep. I felt utterly defeated.

This morning I sent two pleading emails to my lab and clinic to please help me with this and I attached all the paperwork I have. The lab was very helpful saying that they don’t do diagnosis codes because they’re a diagnostic lab and she said that the letter had the diagnosis codes and that should be all I need, she advised calling my billing department at the clinic to find out if I needed anything else. Perhaps receipts for the biopsy of the embryos. The clinic shuffled me off to billing because I could get and itemized receipt from them. Now I’m fucking confused and a bit livid because they never mentioned any of this before. In fact they never helped me with anything about this self claim. They never told me anything about itemized receipts or letters of medical necessity. But I guess I can’t expect them to spoon feed me but still, a little heads up would have been nice. Anyway.

Obviously the young lady in billing had no clue how to help me and shuffled me back to the clinic to speak to the financial coordinator. While she was apologizing my eyes started welling up again and I croaked out a quick thank you before hanging up abruptly. I sent another long email to the financial coordinator explaining what I’m trying to do and why and how desperate I am since I’m going to have to go through all of this again in a few weeks. I don’t know how, at this point, I haven’t snapped. N told me to cc everyone on one email and let them hash it out but even in my rage I still felt guilty about putting everyone on the spot and was worried that I would anger them and have even less chance of getting help. She replied quite quickly saying that she doesn’t know how to help me but she cc’d her supervisor to assist.

A few hours later the supervisor confirmed that the lab sends the itemized bill with the procedure code. The RE sends the letter of medical necessity with the diagnosis codes. She said that I shouldn’t have to submit anything else since the insurance should have the approval on file but she sent over a document with the approval number anyway. And I have an authorization letter from the insurance as well.

Meanwhile I get an email from D saying that there’s been so much back and forth that he’s just going to submit what I gave him and see what happens. Really dude? Are you going to acknowledge that the diagnosis codes are there in the letter? Whatever. I emailed him back and copied the confirmation email from the clinic telling me what I need and the the other email from the lab saying what to get from them and I attached the 2 authorization documents for just in case. I ended of really nicely thanking him for his patience and I was sure that he was about as done with this as I was. He sent a nicer response saying that he’ll get everything attached and see what he can do to get the claim paid.

Phew! All while this was going on I started spotting. My period is expected to start on Thursday and all I could think last night and this morning was that I was over it already. I simply couldn’t get on board with a new cycle just yet. I really haven’t prepped adequately for this cycle. I haven’t been as healthy as I could have been and here it is already. The one good thing I can say is that aside from this insurance thing, I’m not stressed about the cycle at all. I really haven’t given it a second thought aside from last night. I did say that I want to treat it like a trip to the dentist so at least in that regard I’ve been successful.

My meds have been ordered and should be here on Friday. Maybe I’ll be excited by then. Getting the meds is always exciting for me.

Here’s to a stress free round 3. Breathe in, breathe out.

26 thoughts on “CD 1 ish

  1. Perhaps I read this wrong BUT your PGD may be covered by insurance?! What state are you in? Is this something you found out on your own or the doc told you?

    • That’s correct, yes. I’m in Massachusetts. I’m very lucky to be in a state that has mandated insurance coverage for IVF. In that regard, I really don’t have anything to complain about. I was on Rhode Island before and it was covered as well but only 75%.

  2. Wow, reading all that insurance run-around really got my blood pressure up. How stressful and frustrating! You’d think that both those places could get it together without your help since they both do this all the time. Sorry for the headache!

    Good luck on your upcoming cycle!!

  3. Holy moly girl! How have you kept it together? I would have gone freaking postal! I would have at least pulled all my hairs out one by one. I’m sorry that was/is such a cluster. Oy.

    My sister did several IVF cycles, and on her last one she said she was just going to treat it like it was a business. No emotional investment. And she did! And that was the cycle she got pregnant. So I like your plan of treating it like you’re going to the dentist! I always wished I could be more detached from it.

  4. The worst is all the fertility issues and then to have medical bill issues on top of it all. This sounds so exhausting. You are doing great and have such a fighter spirit! Hugs to you and can’t wait to hear about your progress. Xx

  5. So here in the US, it’s illegal to email anything like that. Something about it can be altered after being scanned, blah blah blah. They HAVE to either mail or fax legal documents. Kinda dumb, but that’s what I’ve always been told. Anyway, I hope they get it all figured out for you! Our insurance wouldn’t cover our PGD at all, that’s the one thing we had to pay fully out of pocket. Good luck with this cycle!

  6. Good gravy! Insurance is a mess. I’m struggling with mine as well. They keep denying claims because they keep billing my old insurance from my previous company. The company has been closed for 2 years consequently ending my insurance with them. I’ve got my “new” insurance shortly thereafter and it’s never been an issue until the last month. They are denying EVERYTHING because they are charging the wrong insurance. I think I must be speaking German when talking with them.
    I’m right there with you. deep breathe in and release…

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