Friday, February 29, 2008

Insurance update.

Talked with insurance company.

Let me just say that I ~puffy heart~ this company. It's small and I have ONE contact who is the plan admin for my husband's employer. When I called, I introduced myself and she cut me off saying "I remember you Nancy! How can I help you?". Wow. She knew me by name.

She looked up my account and said it was not denied, it was simply pending for more information. Since I thought all information was already sent, she got me over to the woman on the authorization review team. She was just as nice as the first lady.

She told me the only medical records she's gone through were the ones from my OB. She said they were very thorough and saw had recorded I started with progesterone tests in Jan of 07. She then saw I had been prescribed clomid in January also, even though I didn't start that until my February cycle. What was missing was any record of an IUI, which they need completed before they would pay for IVF. We discovered she did not have any record from my current doctor, explaining I have had 3 IUIs, 1 hcg triggered monitored cycle, 3 surgeries and a butt load of appointments.

It scared me for a moment in that I thought they looked at the first IUI being 12 months prior to IVF eligibility. I asked her if the oral meds cycle I had completed over a year ago "counted", she said "yes."

The medical review lady calmed me down a lot. While I knew she couldn't give me an answer before she received the records, she did elude to the fact I'm starting my cycle in 5 days shouldn't be a problem. She said the process is already started, she's simply requested more info, and as long as she receives it soon, I shouldn't be in panic mode.

After getting off the phone with her, I called the billing girl at my RE's office. She told me that she did, in fact, send over my records, so she acted all defensive. Hey, I don't care who/what/where the records when to, I just need her to respond to the records request. I wasn't yelling at her or anything, so there was no need for her defensiveness - especially in her line of work. Billing for an RE's office must be tough. High emotions on the part of the patient probably have made her this way.

Anywho, I hope that all the records are sent over today and it's all figured out. I'll still start Lupron next Wednesday if I hadn't received all the approvals yet. I already have the meds, so no reason to not start it. Hopefully it won't be all for nothing.

10 comments:

KatieM said...

Whew....sounds like everything is still a go! =)

merks23 said...

This is me: ahhhh, big sigh of relief. I was literally holding my breath until I finished reading your update. Everything will work out. I'm glad you got in touch with them today and that they were so helpful. You are truly blessed!

I've still got my fingers crossed for you, Nancy!

Peace,
jessy :o)

Morgan said...

I'm so happy everything is working out in your favor, you deserve it. I am keeping you in my thoughts and I hope this all works out for you Nancy!

Anonymous said...

WoooHoooo! That is really good news Nancy! I have been thinking about you since yesterday. Lots and Lots of Luck!

~Lindsey
(lav1983)

Jen said...

I am so glad its nearly all ironed out! I wish you all the luck starting next week and if you are a really good girl, maybe we can find you some sassy ruffles on the underwear for pregnant women!

Io said...

Yay for having an awesome freaking insurance company!

Sarah R said...

Whew! That is a big relief. I'm so excited for you! (hugs)

waitinginline said...

I'm glad that everything is working out. Now if they'd just quit scaring you...

Kaci said...

What a relief! I hate that you had this scare, but I'm so glad you have insurance that rocks!

Wordgirl said...

I'm SO glad to hear this.

No more surprises Insurance Company -- you hear me? We CAN'T take it (or, I can't take it...Nancy is a Candy Sni.per so watch out...what position by the way...did I miss that info?)


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