When I arrived home from vacation on Monday night, I was greeted by a very think letter from the billing department of my fertility clinic. I had a bit of a panic attack opening the letter, but it ended up being just a bill for $30. The reason why the letter was so big is that it had 6 pages of "pending" payments from my insurance company. I started going through the bill and it looks like about half the items that they consider pending were already paid by my insurance company with some items paid many months ago. The other items are claims that for some reason my insurance company just chose to reject, even though most of these claims are identical to other claims my insurance company has paid. I think insurance company claims systems are programmed to just reject a certain percentage of all claims regardless of merit.
I'm trying to figure what to do about these "pending" claims. No one is asking me for money yet, but based on past experience, when a provider thinks the insurance company owes them money, if they don't get the money, I eventually get the bill. I have $10,000 per year in infertility coverage and I think I should have enough left to cover all claims, although it may be close. It all gets very complicated very quickly because every visit to the RE generates about 6 different billable items and I had a lot of visits during my 8 total cycles, so it ends up being hundreds of charges that I need to review and potentially negotiate with the finance office later. I was happy to see at least that my visits after the first positive beta do seem to have been coded correctly as OB visits, so they should not count against my fertility coverage.
Yesterday, I called my OB's office to find out my blood results from last week's appointment. I ended up having to call twice because the first time I was told a nurse would call me back, but no one did. I had the results faxed to me. It looks like I'm still blood type O negative just like the 6 times I was tested last pregnancy. I'm also still not a Cystic Fibrosis carrier just as I was not the 2 times I was tested last pregnancy. So, although they managed to run a bunch of unnecessary tests, they did not run the two tests I had actually requested -- my progesterone and thyroid levels. I called the doctor's office and left a message for my doctor asking that she call me and explain why the bloodwork we had agreed upon was not ordered. I got a call back, from a nurse, an hour later explaining that the lab screwed up and that my doctor has submitted the paperwork for my progesterone and thyroid levels to be checked, but for some reason, Quest had not run these tests. I suppose this is an honest mistake and not my doctor's fault, but what I don't understand it why I'm the one that figures out that bloodwork is missing and not her. Again, that makes me feel, as I did during my initial appointment, that she is not being very attentive.
Not checking my thyroid levels is actually a problem. I have had a thyroid condition for 25 years and have been on the same dosage of medication for all that time except when I was pregnant with T and my dosage needed to be increased. Keeping normal thyroid levels is important both for the health of the pregnancy and for appropriate fetal development. I know when I see the high risk doctor on Friday he is not going to be happy that I have not had my levels tested yet. I will need to stop at the OB's office on Friday to get another blood draw.
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1 comments:
I really don't understand why dealing with the medical community needs to be so much work. Between rude front desk staff and docs that can't remember your name, let alone why you are there, it gets very discouraging. We have had similar issues where we have to remind them what they are supposed to be testing and why, to the point where I sometimes just want to scream "why am I fighting with my insurance company to pay you for treating me??" Seriously if I got this kind of service anywhere else I would refuse to pay and write letters to whoever I could find to complain.
I hope that your doc gets their head out of their butt and that things get better on that front. Bravo to you for staying on top of it all. That is a job and half in and of itself and hard to do when you are tired and hormonal and pregnant.
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