Wednesday, May 27, 2009

Friendship Follow Up and Fortunes in Fees

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Thank you for the kind, thoughtful comments on yesterday's post. I am so grateful to all of you for gently caressing my wounds, offering advice, making observations and sharing your own experiences.

I guess in the end it is my own feelings, experiences and vulnerabilities causing the slow erosion of my friendships with J and M. I have to accept responsibility for that. I think I've been sensing the erosion for some time. Partly it is because I am consumed with my own IF matters. Partly it is because the issues and topics they like to discuss simply don't interest or stimulate me. I am easily bored when I spend much time with them. As one person said, sometimes the lifespan of a friendship just reaches it's end. I'm sure I will still maintain relationships with J and M. Perhaps I'm just finally aware of how those relationships have been modified.
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Now on to other things.

A few days ago I lamented having to pay a $125 outside monitoring coordination fee in connection with a single E2 blood draw. Many of my bloggy friends encouraged me to call the clinic and ask about it - it seems to be an outrageous charge.

I called today. Welllll, no definite response yet. I told the person I spoke with that I thought the fee was quite high and I emphasized that this particular charge for a simple blood draw seemed really unfair and I wondered whether the clinic would be willing to waive it. She said she would ask and get back to me. I guess that's something (we'll see if she actually does call me or if I have to call her back). If they decline to waive it, then I will ask for a written, detailed list of "coordination" services they have provided.

On a roll, I also asked whether the clinic would be willing to negotiate with me on the fee since we will be doing another cycle and my insurance doesn't cover this. Her explanation for the $125 coordination fee is that they discovered they often spent a lot of time tracking down orders from primary clinics, following up with 3rd party participants (like surrogates or donors), and using staff time to obtain information and coordinate appointments. I told her I understood and that made sense, but that in my case, I am the one making sure they receive the orders, and I do all the following up, and there are no 3rd parties involved. I thought it would be fair if they only charged me half the fee. She hemmed and hawed. She wouldn't commit to asking about a lower fee, but I got the administrator's name and said I'd be happy to talk with that person myself.


Then I was really pumped and called our insurance company. I'm on my DH's insurance and his employer switched insurers as of May 1. I decided to call and ask about IF coverage. You know I wasn't expecting a doggone thing. Well, as it turns out, I got the sweeeeeetest woman representative on the phone. I ended up discussing the particulars with her and she was over there checking diagnosis and billing codes for me. She thought some of the costs charged by the outside monitoring clinic might be covered! Okay, not the $125 fee, but perhaps the cost of the U/S's and b/w. Wow! Now that would be something. She showed me where to get a claim form online and is going to have me fax it to her directly. She also encouraged me to find out the billing codes for the FET and I could call her back directly at her extension and she would check those for me too. What a sweetheart!

There's no telling whether one dime will end up back in my pocket from the outside clinic or any of the FET charges, but it's possible! I think I have a fair shot of at least getting some of it reimbursed. And I have you guys to thank for urging me to call and follow up! Thank you, thank you, thank you! I almost feel like I should be paying you a consultation fee! Well....almost. :)
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5 comments:

Anonymous said...

good for you for taking charge with the re's office and the insurance company! i find that stuff intimidating and exhausting.

best of luck with your next cycle.

iclw

K said...

Wow...you ARE so lucky to get the nice billing lady on the phone. That's a bit like striking gold in and of itself! But, if you want to get anything done...you gotta do it yourself. Sounds like you might be successful. Hopefully in more ways than one! ;)

Alex P said...

wow. you should just keep her number and call her with good news and keep her as a friend instead of J and M. naughty ladies. Sometimes kids say crazy and cruel things, but at least they are innocent. sometimes people are just.... awful. cheers for being above them!

stillhopeful said...

Good for you! Doesn't it feel so great when you make the calls, do the research, and it becomes financially beneficial?!? I hope it works out - it sounds very promising!

Anonymous said...

So impressed that you followed through on the billing/insurance calls - such a pain but sounds like you may get something for your trouble! At least you have rattled the chain, and those people really need to be aware that they are sending fees to real people, it's not just a bunch of numbers on paper.

Missed your post yesterday, sorry your friends are not on this journey with you, but hopefully you have some new friends that are. I know you have lots of support in the blog-o-sphere! I have had similar experiences with friends that just have no idea what I'm going through. Sometimes that's ok, they are still nice people I can have a good time with. But sometimes I just don't want to deal with people who don't "get" it. Good luck in this new phase of the friendship!