Friday, March 15, 2013

Saline Infusion Sonogram

My SIS was on Wednesday.  It came with a little bit of stress before hand though.  Less than 24 hours before my appointment, I was informed that $736.87 would be due upon my arrival.  I was expecting maybe a few hundred.  I was not expecting over $700!!

I responded to the financial advisor (FA) questioning the large amount and if my insurance would cover any part of it since it was a diagnostic appointment.  My insurance covers NO part of infertility treatments, but they do cover diagnostics.  Every single thing has been out of pocket (or a loan that we are paying off).  I had thought since this was to check my uterus following the D&C and to look for polyps or fibroids that might have developed, that this procedure would be covered, even if only a little bit.  I asked if there was any way the appointment could be coded differently.  FA (you can read that as Financial Advisor or F-ing A**hole, you decide) informed me that because this was an infertility appointment, it would not be covered.  He also proceeded to inform me that "coding is done by the physicians and it is inappropriate for me to ask them to code it differently."

Really?  I mean, really!!!  I was so pissed off when I read that message.  It's inappropriate for me to ask why I am having to spend $736.87 less than 24 hours before the appointment?  Like I have that kind of money just sitting around that I can just pull out of my pocket at the drop of a hat.  It's inappropriate for me to ASK?  What. the. bloody. hell!

It's not like I was asking them to LIE about it!  I do know that there are different ways you can code these things.  I do take responsibility for the fact that I could have and should have checked on this sooner, but quite frankly, I didn't know I needed to.  For the last 16 months of IF treatments and working with this clinic, I have never been blind sided by such a large amount before.  I also realize that maybe it was a complete misunderstanding on my part what this appointment was for.  Was it something I could have gone to my own OB/GYN for and paid less for the same results?  Probably, but I LIKE my RE.  I didn't question scheduling this appointment with her.  I was looking forward to seeing her.  It didn't even cross my mind NOT to go to the IF clinic.  And I was given less than 24 hours notice for the amount due, so I felt like I had no choice.  It was too late to cancel.  I got the message about the amount the night before and my appointment was at 11:45am so I had no time to cancel or look into it at all before the appointment.

I decided I was going to talk to Dr. W about it anyway, even though it was "inappropriate" to do so.  I am so glad I did.  When she started talking to me about the SIS procedure, I asked if this was a follow up to my D&C to see if everything was all clear in my uterus, and to check for fibroids/polyps.  She confirmed that it was.  Then I got all (embarrassingly) emotional and told her what FA had said.  Dr. W said it was absolutely NO problem to code it as a necessary procedure due to the D&C, rather than for simply IF reasons.  She said that happens all the time.  She also said that FA doesn't have a medical background and doesn't know my history.  He just does the billing.  I can understand that, although it still pisses me off that he said it was inappropriate to ask.  It's also unfortunate that I had to pay $736.87 just to see Dr. W in the first place.  I still don't know what or even if insurance will cover any of it, but I feel much better (and justified) about the fact that I have a chance of that happening, and maybe I will get some money back.  I'm not sure how that will work out.

The great news from the day was that my uterus is all clear!  I have no scar tissue and no polyps to be concerned about.  We are ready to move forward with the FET.  Now it's just a matter of waiting for AF to come for her next visit, which should be sometime the first week of April.  I'm very ready to move forward.  Now to just get through my softball season.....

*I do want to say that I absolutely love my clinic and the RE's and I would highly recommend them to anyone.  I've only ever had billing issues and one bad experience with one nurse, which was fired shortly after my incident with her.  That's something that happened before I started blogging, but would definitely be a worthy blog post!  All the other nurses and the doctor's have been amazing.  Even the receptionist knows me by name.  Wait...maybe that is a bad thing because I've had to go in so many times over the past year and a half!  haha!

28 comments:

  1. So glad your RE was able to work it out! It really does depend on how things are described...my plan doesn't cover acupuncture, but if it's done by a chiro or massage therapist and they just call it "chiro/massage appointment" then it's totally fine. That FA was definitely being the second of your two descriptions.

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    1. I've been told by many and have read several times about using different coding for insurance purposes. I didn't think it was a big deal to ask, but he made me feel like I was being so immoral. It was rediculous. It's so nice that you can have it changed for your chiro and massage appointments!

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  2. When my SIL was getting her testing done to be our surrogate, I knew it was standard yearly appt things (STD testing, etc.) so I asked the IVF clinic how much they charged for these test (thousands!!) and then I had my SIL schedule an OB appt. sure enough it cost $82 total just going through the OB! It's really a shame that it's so much more costly going to the RE, I sure hope they reimburse you! They could have billed it and gave you the money and just rebilled you for the correct amount later, that FA is a REAL FA! Congrats on being ready for your FET though! :)

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    1. Now I know....I guess I was just to naive to figure it out sooner! I'm just glad my RE was on the same page with me. That is an insane difference on those tests for your SIL. Crazy!

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    2. Yep, I STILL had to pay for drug screen and the saline sono to the tune of $480, plus the $160 for the consult, but I figured it was a steal after hearing the $2075 I was originally quoted and it sure was the billing person who told me.. Now that I think about it, she was giving me a hard time about breaking the testing up, but I asked the nurse and she said it was no problem (After the billing girl told her to just send it downstairs to their lab!) HA, you just made me remember that first day was crazy dealing with billing!! Definitely stay on them about it so they don't just forget and you don't get reimbursed!

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  3. I have heard the MDs are really good at helping out up there! As a "biller" for a medical office, I would never say that. I always say "that is something I would recommend disussing with your doctor." ;-)

    I try to do as much of my testing thorugh my OB as I can... much cheaper!

    I am so excited to enter this FET journey with you!

    Hugs!

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    1. See, if he had said something like that, I would have totally though nothing of it. He just made it seem like I was out of line even asking. I'm still learning....

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  4. so glad things worked out for you with the billing and the results. My RE told me that while he truly didn't think my septum contributed to my miscarriage, he noted it as possibility and put it in my chart, so we could use a different dignosis for my resection. I had to laugh at the FA appreviation as in England "FA" refers to 'Fuck all' As in, the FA at your office did fuck all to help you and is a fucking asshole!

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    1. Sorry for the actual language -your blog is 'family friendly'

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    2. Haha! I was laughing at your "actual language." I do try not to use foul language too much, but sometimes it is just necessary! It's so nice when the doctor's work with you on things like that. I'm glad your RE was willing to put it in your chart that way so you would be covered.

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    3. My DH said "You cuss on your blog?" I forget who reads it sometimes.. but sometimes I just have to let the F bomb fly... you all understand, right!? <3

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  5. Wow, that's just terrible. I'm glad you got it worked out (and can totally sympathize with you), and it would be nice if the entire staff could act professionally. I've had some troubles with the billing office with my RE when I was double charged for a $2000 service, and it amazed me the level of indignation and condescension that I had to deal with.

    Now you have me thinking about how my SIS will be coded. I think I will call in advance!!!! :)

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    1. Yes, definitely check on it in advance! I wish I had. I just tend to go with the flow and that sometimes gets me in trouble.

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  6. That financial person sounds like a bit of a jerk. So glad you asked your RE even though you were discouraged to do so. My insurance always covers procedures like that but nothing really IVF related.

    So glad the procedure went well and everything was all clear moving forward!

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    1. yeah, he really is a jerk. I haven't enjoyed dealing with him. But now we are ready to move ahead :)

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  7. Yay for a clear sonogram! I hate that infertility stuff isn't covered for everyone. That is just wrong.

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  8. the money thing is ridiculous! but i am so glad you are cleaed..get the show on the road!

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    1. I can't WAIT to get the show on the road!

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  9. Let's hear the story of what happened when the person got fired! I am so glad you like your RE and clinic so much. I was NOT A big fan of my last clinic and
    I am really hoping to have a better experience with the new clinic.

    Its such a good thing that you spoke up about the coding, even though that jerk told you not to.

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    1. haha! Okay, I will have to share that story sometime. It is a doozy. I am thinking about you this week! So excited for you to get to Cancun tomorrow and to cheer you on as you go through IVF #2!

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  10. The man in the billing office was a jerk. There was no reason to say that to you. Recoding if they can is pretty common.

    When I had my lap done, there was some concern insurance wouldn't cover it if my RE did the surgery instead of the OB. In the end, it was approved because I had what was "thought" to be endo pain. Ahem. Coding play at its best right there. ;) (It ended up being lots and lots and lots of scar tissue from my c-section, and I should have been in a whole hell of a lot more pain than I described according to the doctor.)

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    1. I hear from so many people that coding "play" takes place. It shouldn't have been so unheard of for me to ask. He really was just being a jerk. Anyway... I'm glad you didn't actually have as much pain as the doctor thought you should be in! I still need to go back and start your story from the beginning. I am hoping to do that soon, but it may not happen until after softball season. I don't have time for much this time of year.

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  11. I wanted to email you back but I didn't have your email address!

    You asked about the sports I played in college- I played tennis and I was also a thrower on the track team.

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    1. Oh, thank you for your response!!! My email is pantheramber@gmail.com

      Being such a big sports fan and a coach, I am always super impressed with anyone that puts the time and dedication into their sport to play in college. I know how much work that takes! I grew up playing volleyball, basketball, and softball. I now have been coaching softball for 20 years. I try to play tennis, but I'm not very good which drives me crazy. It's such a good sport!

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  12. I'm so glad your RE was comforting for you, that just seemed crazy for them to say it couldn't be coded a different way. Mine seems to work with us as well since insurance only covers diagnosis as well. That's great news that everything is clear :)

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  13. GOOD GIRL for talking to your RE!!! All they can do is say no, so it never hurts to ask a question! There are no silly questions!! So glad to hear that all is clear!!! Keeping the prayers going!!! Auntie

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  14. I think that's great that all of your test results came back positive! Even though there was a little stress before the appointment, I'm glad everything turned out okay for you. I'm anxious to hear about your next visit and how it goes. You'll have to keep everyone updated! http://www.allwomensclinic.com/services.html

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