March 24, 2009

Story of my Effing life!!

I had this great post all planned out in my head when I walked out the door this morning, but by 2 PM it had been shot right to hell.

I was going to tell you all about how I feel about this upcoming cycle, and post a pic of all the drugs I got from the pharmacy for said cycle. I can't do either right now because I am still so pissed off that I want to strangle someone.

Turtle and I had lunch today with Clark early so that I could head to the pharmacy to pick up my meds. After we ate and Little Miss played her ass off for what seemed like an hour, we left and headed to make our pick up. Got there and told the guy what I was there to get, he said to give him a few minutes to get it all ready. Turtle ran the store while he did that.

I came back when he told me it was ready, and he rang it up, looks at me and says"That will be $6792.33 please." I think I had a minor heart attack right there. I told him that I had insurance, and he said oh ok, let me run it. We waited about 20 minutes, and he comes back up and tell me that the insurance is declining my claim. I asked if he knew why, and he said it was because there is no authorization for this IVF.

What the FUCK??

I was just going to call them, but since the clinic is only about 10 blocks from the pharmacy, I drove over. I asked to speak to the woman that handles the insurance stuff, and after about 10 minutes she came to get me. We go back to her office, and she says "Ok just so you know we have no idea why WeSuck InsCo won't pay for this.

Huh?? I asked her what she was talking about, and she says "Well you are here about your last cycle and why they didn't pay for your transfer right??"

"Uh nope, I am here to find out why you guys didn't get authorized for the cycle I start in 2 freaking days!!"

To which I get a total look of surprise.

"I didn't know you were doing another cycle again much less starting in 2 days."

So I tell her about trying to get the meds, and she looks up in my chart, and all the info is there, but no one told her that we were doing this cycle. Just freaking great, it takes at least 48 hours to get WeSuck to approve a cycle, and I have less then that before I am supposed to be at the clinic for monitoring.


So she quickly faxes the papers over to WeSuck and we cross our fingers. I then asked her to explain to me what she was talking about when I first got there, and she told me that WeSuck had sent a letter saying that they were not paying for the embryo prep or transfer for our last cycle in January. No details just that they weren't paying it, and that I would have to appeal if I felt they had made a mistake, but it was out of the clinics hands now.

Before I left, I told her that I was sorry that this whole mess was my fault. She looked at me and asked me what I meant, and I simply told her that it was my fault because I ASSUMED that they all communicated.

I left, and drove home, even though I had planned to do some other things, so that I could call WeSuck and ask them what the hell.

Moron #1 at WeSuck tells me, after looking it up in her handy little computer that I didn't have an embryo transfer I had an embryo TRANSPLANT, and they don't cover those. I literally spit soda out my nose when she said that. I have no idea who in the hell who wrote the exclusions, but Embryo Transplants haven't been done in over 20 years, and I am not a farm animal, so it doesn't count in this situation. After spending 15 minutes trying to explain the differences, I asked if I could just talk to someone in the IF department... She tells me this "Oh no, they don't talk to the members at all." HUH??? Come on, you have a department who approves IVF's, but cannot talk to me to get this sorted out?? I finally asked her to put me through to someone who had a little more brains.... and yes I said it just like that. She sent me to a "Resolution" team member who did understand, and agreed that it should have been covered, and that she was going to submit it for review.

So, now I wait. I have more, but it will have to wait for tomorrow since the Turtle is still working on her SRT certificate... oh what you don't know SRT?? You do........

Sleep Resistance Training........ Nuff said!!!


Kristin said...

Oh man what a major clusterfuck! I am so sorry hon.

Rhonda said...

Oh. Shit.

'Nuff said there too.

Good luck my friend!

Kibbles said...

Wow. Just WOW...
What the heck????

Anonymous said...

Do you have leftover progesterone? Just a thought... but a few day's stall could help while you wait for the ins people to get an IQ transplant? Even if you don't have leftover.. the supps are cheap enough. I never post.. I get shy in the IF world.. BUT I wanted to see if that might work. My RE is stalling my AF with Prog. b/c I can't use the pill.

Praying for you.

Anonymous said...

Honey....pack up the family and come over here.....we have "normal" people in our health insurance companys and in all the time I had treatments I never once went through this shyte. Meds were part of the package and the out of pocket was minimal....its like a whole new world....and the BIG plus....well that would be ME!!!!
Tesi (the vague who STILL doesnt remember that damned password)

Anonymous said...

please see the link >

Kristine said...

Blah! That sucks big time. Hope it all gets sorted out super fast. I'll be waiting for an update.

Susan said...

Fucking insurance companies.

Anonymous said...

I hate insurance companies. Hope it us sorted soon.

Tracey said...

I just went to the crappy site! We need to bombard him with some lovely comments of our own! What do you say!

Erin said...

Insurance companies are idiots. It's hard to get a huge corporation classified that way, but they somehow manage to do it.