Three Times a Charm

I think I am getting the hang of this IUI thing now.  I understand exactly what is going to happen each day, what drugs to take, what side effect will happen and when, who to speak to on the phone, who NOT to speak to on phone, how to ask for what I want, how to make myself understood, how to refill my various prescriptions, what bills to expect, even what emotions I am probably going to feel on this roller coaster of a cycle.  For example, I am on Cycle Day 4, and having taken two 2.5mg of Letrozole last night at 7pm, I knew at approximately 4pm Today I was going to be mega sleepy.  And I was! Where I work, if you have done something more than twice you are considered an expert, so I’m going to declare myself “IUI Subject Matter Expert” on my “CV of life”.  I’m feeling quite chilled out about it all, that is except for one, teeny, tiny, annoying thing.

INSURANCE.

The thorn in my side right now.  Needles have nothing compared to this pain in the….

You may recall before we started IUI that my insurance company wrongly stated that I did not need pre-approval for IUI treatment.  It was only after I started my first cycle all became apparent that we needed pre-approval before any fertility treatment.  Since then, we have been trying to get things straight with our insurance company.  I am not entirely blaming the insurance company here.  I am blaming ‘the system’.

It seemed so simple, our insurance company required copies of our medical records to determine pre-approval for our IUI treatment.  Well that’s easy! No? Fertility clinic – please provide our insurance company with our medical records.  “No problem, we will get the nurse right on that” they said.  Well each week we chased them, they claimed no knowledge of this request, but wait, what is this? …oh there is a note in our records to do this.  Hmmmmmm.  At our last appointment 2.5 weeks ago, the nurse promised us the request to send the medical files was with their business team and they were going to action it that day.  Well it turned out that was all bull.  No medical records were ever sent because we had to fill out a release ‘form’.  And after the number of people we spoke to try to make this happen, not one person mentioned a form.  Things also got complicated when the fertility clinic realised that our insurance’s medical office is located in Belgium.  This would be impossible! Sending medical records abroad – there are different laws for this. They were not quite sure how they are going to do it,  come on, surely there is a form for that too!  How about I google it, I bet google knows the answer.

So after we hit this road block, Chris tried a different approach.  He has given the half completed ‘pre-approval’ forms to our insurance company to chase up with our fertility clinic.  When my insurance company emailed me this morning to say could I please provide them with a contact number for my doctor, oh, by the way we would need approval for each round of IVF….I flipped!  As you can imagine we had dutifully and carefully provided a contact number and address, but most importantly, it clearly stated on the form the treatment was IUI.  I even provided them with a breakdown of all the costs for each procedure and medication.  Aghhhhhhhhh!

I have no idea what is going on right now, but it is all now in the hands of the insurance company and our fertility clinic to figure our laws, methods of handling medical records, procedures, money and what not.  Why couldn’t we have got to this stage two months ago?  At this rate we will probably get our “pre-approval” for IUI after we have finished all three rounds of IUI!

Without pre-approval we have paid for our first round of IUI out of our pockets and hoping we will be able to claim some money back.  Soon the bills will be coming in for the second round of treatment.  It would be nice if they figured it out before then.  My worst nightmare is that they deny the claim because there was a small test we had to do or form we had to complete before we started with the IUI.  There is little advice the insurance company can provide us on whether we are covered or not until they have our medical records.  Similarly, they can’t answer if we are covered for IVF until they see our medical records.  This makes financial planning for the future a little challenging.  But we are planning for the worst, just to be safe.

I should point out that we do have a rather strange insurance arrangement – because my organisation is international, Allianz, our insurance company, provides coverage for all staff across the various countries.  Allianz uses United Healthcare as their service provider in the US to purely deal with admin for claims made in the USA and negotiate in network deals with providers.  This makes things complicated for medical providers here in the US when we try to explain that they have to provide medical records to Allianz, not United Healthcare.  I hope I didn’t lose you there!

So to sum up today’s post – Insurance sucks and starting IUI cycle 3 is going to be a breeze.  As the saying goes….third time lucky!  Or….third time a charm!  Let’s hope it’s not like the other google search term on the list above – third time out :-s