February 26, 2012

It never hurts to ask.

It's shocking how much infertility can cost. Especially when your insurance doesn't cover it.

Mr. Bossy and I are OOP for all infertility procedures. Fortunately, my hysteroscopy was covered by insurance due to my PCOS diagnosis, and I do receive free metformin from our local grocery store's pharmacy because of their fight against diabetes. But nothing else is covered. Florida BCBS just doesn't have it in their plan.

We knew this when we began our journey, and we've been blessed with a generous family. We went with the Attain Program that works exclusively with our clinic. We paid $15,700 for four attempts (two fresh and two frozen). Meds for our first fresh cycle amounted to almost $3,000! Our RE is positive that one of our attempts will result in our take home baby.

After the d&c, Mr. Bossy and I returned to see our RE to discuss the FET protocol. As we were leaving, I spoke with the receptionist to pay for our visit (Insurance does cover for me to see a specialist. My co-pay is $40 per visit). The receptionist told me that we had a previous unpaid balance. [ I remembered receiving a statement in the mail from the clinic a few weeks prior with an amount that I didn't agree with. At the time, I called the billing department and spoke with someone in charge. She agreed that something wasn't adding up, and she would have her boss look over my account with a "fine-toothed comb."] I relayed the information to the receptionist, and she told me that the amount had become larger due to insurance not covering the entire d&c. Everything totaled to almost $500. I was livid. The receptionist was really nice, and told me that she would write a note on my account to have the billing department call me again. I did NOT pay the full amount that day. I had some calls to make.

I called my insurance company to question the amount that was not covered. I'm typically a very go-with-the-flow kind of person. I do what I'm told, and I don't rock the boat. Infertility costs have changed me entirely. I wanted to know why I owed such a large amount. A d&c is not infertility. Fertile women have miscarriages all of the time. I needed answers.

I spoke with a representative from BCBS. Now- with all of my anger, I was still able to be polite. I realize that the person on the other end of the line is not personally responsible for any mistakes that were made and being nasty to them isn't going to help the situation. I explained that I didn't understand the amount that I owed and it was more than I had expected to pay. The woman from BCBS was SO nice. As I explained our IVF and d&c, I began to cry. She completely understood, and she worked feverishly to find out why my coverage was denied. It took some time on the phone, but she agreed that insurance should have covered the entire procedure, and I should have only been charged my co-pay - $40! She submitted the claim to be re-reviewed and told me it would be about 30 business days until they made a decision. I told the representative that she was officially my new best friend!

The anesthesiologist had also charged me too much, and BCBS submitted that claim to be reprocessed. I was walking on air!

Yesterday- I received a new statement in the mail from BCBS saying that they had reprocessed my claim. I, now, only have to pay $40! When in doubt, it never hurts to ask!

Bossy Bud


Diva Bud said...

Kudos to you for checking things out! Sometimes we get busy or lazy, and it makes it hard to stay on top of these things and really follow up :) Congrats!


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