Insurance Issues

Whew. Been a while since my last post. With trying to tie things up at work and get packed for our vacation, there was no time to post. And so much for the Wi-Fi connection at the campground we went to last week… it didn’t, connect I mean. One of the girls I was with is a E-Bay store owner, and was the first to let us know that it didn’t work. I didn’t catch on until Thursday that she actually left the campground every day to visit the little town library and log on. Had I only known!

We didn’t try on our own. Not at all. I think we have had sex once all of last month, and it was nowhere near when I was O’ing. And I spent most of last week on the little beach at the lake on the campground with stomach issues (we think that many of us had some kind of 24-hour virus). I couldn’t even really enjoy drinking cosmos until Wednesday (made up for it Thursday and Friday though).

About midweek, I got a little nervous because I finally looked a calendar, and realized that, thanks to the meds from last month, there was a chance AF would start while we were in the middle of nowhere. Then the fun would begin. Would I let another cycle pass without trying, or would I come home early, leaving DH and the boys alone to finish our vacation? Well, Mother Nature loves me this month, because AF didn’t arrive until Saturday morning, the day we were headed home. Checked out, drove through a monsoon (remnants of Tropical Storm Beryl), and got home safe and sound. Once we had unpacked the van and the trailer (we borrowed my dad’s utility trailer so that we only had to take one car), I called the Center to let them know it was CD1, and I planned on driving down Sunday morning for CD2 u/s and bloodwork for IUI #2.

SURPRISE!!! The nurse tells me that there’s an insurance hold on my file, and that I’ll have to clear it with my provider Monday. I have to clear it Monday, so that I can come in for CD4 u/s and bloodwork, otherwise the cycle is off. Oh, and the hold was placed on Thursday the 20th.

WHAT?!?! Not one letter in our mail. Not one phone message saying “hey, by the way, we’ve got a small problem with your insurance.” Nothing. Now I’m pissed. If one frigging mistake costs me a cycle, I’m going to have someone’s job. I don’t care anymore.

I take a hard look at the insurance company’s website (BTW, it’s Tufts for anyone wondering) to see if there’s anything I’m missing. And lo and behold, there it is. As of August 1st, Tufts is “implementing a prior authorization requirement for gonadotropin therapy and intrauterine insemination (IUI) when used in conjunction with gonadotropin therapy for all female Members.” Problem: it’s not AUGUST 1st!

Can you guess who was on the phone with Tufts at 8:00 a.m. Monday? Yep, me. Then I left a message for the Insurance department at the Center. Pretty direct, stating very directly that between the Center and Tufts they needed to clear this hold by 3:00 p.m. or supervisors on both ends would be brought in, because I was not going to cancel a cycle due to an insurance paperwork glitch. No way. Hyperstim? Sure. Bad lining? No problem. But someone not checking a box on some obscure goddamn form? No!

Was assured by the first Tufts rep the hold had nothing to do with the Aug. 1 policy. Just have them fax an approval form over and ask for it to be expedited. L. the Insurance Czar (very snippy at times) returned my call, telling me that she had sent the paperwork in on Thursday, and hadn’t heard back from Tufts. She’ll “follow up”. Yeh, well, so won’t I, honey, because you really don’t seem like you care if another month passes me by. That or you’ve heard the saga one too many times to have any compassion left in your voice.

I call Tufts back, and finally get a competent ART rep. Guess what? It is the policy. It was enforced prior to its deadline, so she speaks with her supervisor and actually calls me back to tell me that she’s cleared everything up. Give that girl a great big hand, folks! I thank her profusely, and get her direct number (score!). She adds that my insurance office will be calling me shortly.

Hah! Two hours later, L. calls. She’s none too pleased when I correct one of the bits of information she’s giving me and tell her that L. the Tufts rep already called me. The rest of the story: speak with L. at Tufts again regarding meds, speak with the nurse regarding tomorrow’s appointments for u/s and bloodwork, and then speak with the pharmacy three times so that I can drive up and pick everything up, which, of course, isn’t ready when I finally get there at 7:00 p.m. Finally got home at 8:00 p.m., and then had to call one of my friends to ask if I could drop the boys off at her house at say, 7:00 a.m., and she could drop the boys off at their day camp at 9:00 a.m. Thank God I have friends like her, because I couldn't do this. She, without hesitation, said okay. She, who is diabetic and used to needles, who volunteered to give me my shots if I couldn't do it myself. I hope that all of the other IF bloggers out there are lucky enough to have someone like C. in their lives.