Wednesday, June 06, 2007

Put me on the payroll.

Sometimes I feel as if my doctor's office should be paying me. I firmly believe that as a patient you must be an advocate for yourself. I believe that as an IF patient I should be as educated as possible about procedures, what comes next, percentages, side effects and what my insurance will and won't cover. However, I also believe that a great doctor and his staff should make you feel like it isn't so important that you know everything because they know everything and are on the ball about it.

Now, I love Dr. K (my RE) and Dr. D (my OB/GYN) but both of their offices frustrate me to no end. I spoke with Dr. K's office a few weeks ago and they told me that IVF was completely covered. I called my insurance company to make sure. The lady on the phone at the insurance company also told me that IVF was totally covered. At the end of our conversation she asked, "Would you like me to send you a copy of the policy?" I thought, "Why not? Sounds great." A few days later it arrived.....20+ pages of information and medical-jargon. I started reading for "fun" and discovered a sentence on page 3 that dealt with some requirements for covering IVF if you have unexplained infertility. The insurance company requires 3 medicated IUIs (injectible gonadatropins). It says it just like that.....3 medicated IUIs and the injectibles part is in parenthesis.
So, I called Dr. K's office right away to discuss this with them. The insurance girl wasn't there but the receptionist kept saying "but you had 3 medicated IUIs." I kept telling her, "Yes but two were only with clomid." She started to explain how Dr. K puts his patients on clomid and injectibles at the same time......as if I didn't remember giving myself the shots!!! Anyway, I finally talked to Erica and she said she would look into it. I brought her a copy of the policy so she would understand EXACTLY what I was talking about....that was a week ago.
We arrived home from our vacation yesterday (It was awesome....more about that later)....so I called to check on the situation and they are still waiting on some stuff and didn't know BLAH BLAH BLAH. Well I explained that we're on CD 26 here and I needed to know which protocol to start next week.....hopefully they'll get on the ball.

The mail came today and in it was a bill from our RE. We are being charged for our consultation appointment which the insurance won't cover......because the RE's office filed it incorrectly. I spoke with the insurance company and confirmed that yes they cover the consultation but that it is filed incorrectly. I've told Dr. K's office at least twice that they needed to refile and I wasn't going to pay it because it just needed to be refiled.

So maybe Dr. K should just put me on the payroll since I'm the one tracking down whether or not my insurance covers procedures and I'm the one doing the leg work to figure out why they've denied a claim that should've been covered. I wonder if he's accepting resumes. Do I get an employee discount on my treatments??

**Disclaimer: I LOVE Dr. K and Dr. D. I LOVE LOVE LOVE them.....which is why I'm willing to deal with their crazy offices. I actually really like their nurses when I'm in the office and the insurance girl at Dr. K's has been nothing but nice.

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2 Comments:

Blogger Diana said...

Welcome back from your vacation and cheers to you for taking charge like this. I would hate to get blindsided by and IVF bill because of fine print!

11:05 AM  
Blogger Rachel said...

Yuck, that totally sucks! :-( At least you're awesome and know what to do and where to look for answers! How sucky if you'd gone through IVF and THEN found out it was covered!!

BTW I'm from the nest :-)

12:18 PM  

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