Sunday, November 18, 2012
It's over...
The insurance fiasco that is! Anthem has finally approved all the denied claims that were left hanging for a year and a half. They have processed them on my account and I just saw that they were out of "pending" statuses. I also called the RE billing office and they have received payment for those services. I'm also getting receipts reflecting this change in the mail.
Which means that it is a final decision and a nice little check is coming in!
It's becoming real that they aren't going to be wishy-washy. Even when I got my claims through the appeal process and I got a letter, something would happen and that decision was "changed". I also remembered that they made numerous errors in their computer system and "lost" my letter that I faxed over to them many times. Jer and I are hoping that they do send the check very soon (probably after Thanksgiving) so we can get the vacation paid off. Once the cruise has been paid in full, we can schedule activities that we want to do in the Bahamas.
We have booked our hotel and are doing things differently this time around. Instead of staying on Disney property, we decided to stay on Universal property at the Hard Rock. I hope that we don't regret it but it looks like a nice hotel to stay and Universal offers the same incentives that Disney gives when you stay at their hotels. I do like the new tickets where you can pass the lines (or go in one that is shorter). It's like Fast Pass at Disney but instead of coming back at the time it gives you, you stand in a different (and sometimes much shorter) queue line. On our honeymoon, Universal just started offering them and sold them for fifty dollars. We liked them and depending on what time of day, you could go on the rides more than once (not supposed to because staff will initial that you were on it). Jer is a Harry Potter fan so he wants to go there but also they made minor changes to rides. Plus, they have a Margaritaville on the City Walk and has delicious food. The next thing to complete will be the airline tickets. I don't think that we will be able to drive down to Florida like we usually do because I won't get an extra day off to do this. Plus, it will be so much more expensive to park the car when we go on the cruise.
Labels: Cruise, Disney, insurance, TTC, Universal
Saturday, November 10, 2012
Lonely
As I cry in my wine, I just think of what I should be doing right now. Going online to check the latest toys and to the mall to decide what my children should be wearing for the holidays. Instead, I hold a very heavy heart that in a couple more weeks will be two of my EDD's and still I'm not pregnant. December 13th and the second one we were unsure because of how people judged us when we were 22. I think it would have been around Christmas time but I would never know. The college that told me that I was pregnant were pro-life and heavily tried to get us to adopt, so they weren't telling us much.
The good news is that the insurance has looked through all of the claims and will be approving them since everything has been approved that Anthem should have paid for it. We'll be getting a lot of money back and it will pay off our vacation in October 2013! I was really reconsidering to go to Sandals because I would have had to save a little bit more to completely pay that off. However, I think the cruise will be really exciting and if I like the Bahamas, we'll consider doing the Sandals thing in a couple of years. Also, I will be given information to who I have to talk to from my insurance that has a direct relationship with my husband's company that knows their EoB. Once they know our procedures will be covered, the manager will most likely approve it in their system or give me a preauthorization number to give to my specialist's office. I'm so glad that I didn't take the advice of both the original advocate I worked with and the billing office and to quit. This is something that I needed to fight, because what if I needed IVF? Without this coverage, that wouldn't of been an option.
Labels: Cruise, Disney, insurance, IVF, miscarriage, TTC
Thursday, November 1, 2012
Let the good times roll!
Even better news....Anthem decided to finally say that everything should have been paid for with my insurance! I guess the issue was that in some of the EoB's, it stated that Anthem wasn't going to be paying for certain procedures while my husband's company copies of the EoB stated that Anthem needed to pay for them. During this time, Anthem wasn't calling back and making the advocate play around. This afternoon, she let me know that Anthem spoke to my husband's company and everything was taken care of. Right now, they are working on getting the claims approved and attempting to implement a system in which this won't happen again.
Labels: insurance
Saturday, September 8, 2012
The saga continues
The hubster and I discussed it and we're going on a indefinate TTC break. It's going to be for a year so we can save up and go on a Disney Cruise and stay at Universal. He is a big Harry Potter fan and he's been wanting to go since it opened. We had planned to go down there every year but with the miscarriage and treatments, we didn't have it in the budget.
Until now.
The insurance will not pay for what they should be paying (just the ultrasounds for follie checks) and now they are researching the claims that were approved. I know for sure that the IUI and diagnosed scans will be approved because I had to go through appeals for them. But I don't know what they will find to determine why they're not covering it. Anthem has told me that there will be a possibility for me to not to be able to use the lifetime benefit for IUI's because I'm not diagnosed with anything. I find it frustrating that there's a gap of five years between my losses and there's no explaination as to why that occurs. I've tried everything, including changing my diet so I could get pregnant and I'm still with empty arms.
We're going to the Bahamas on the Disney Dream in 2013! We've never been on a cruise, much less a Disney one and it looks fun. There's things that adults can also do too. I booked it last weekend so it's going to be a long wait but I'm planning to save enough so we can do other things in Nassau. I always wanted to swim with the dolphins so I'm going to try to book that. We both agreed to do somethings we normally wouldn't do, so we won't have any regrets once we are graced with a baby. Hopefully, the Walt Disney World will be done upgrading Magic Kingdom so we can just go there for a day. But mostly this year we're going to just go to Universal.
I have lost the weight that I gained from fertility treatments but I'm wanting to get back in shape and lose at least five more pounds (I used to be 115 and now I'm 120) before we go. I have been using a natural detox drink two times a day and I'm beginning to feel so much better! I used to get so sick off of anything that I ate (no matter if it was gluten free) but since I've been doing this, I have more energy and I can keep things down.
Labels: Cruise, Disney, Disney Dream, Harry Potter, infertility, insurance, miscarriage, TTC, Universal
Sunday, August 12, 2012
Major Updates
I haven't had the time to get on and update because there were so many things that have happened recently. Grab the popcorn and here's all the catching up!
Last Monday, my husband had to go for another back surgery. Over ten years ago, he hurt himself at work and there was a big ol' battle from workman's comp to get him just the surgery. Two years of fighting in court, he did get it. However, the doctor that he was referred to when he moved up here told him that the bone was degrading significantly. If my husband let it continue, he would have been paralyzed from the waist down. He had his vertebrae fused together and also has bolts inside too was the only way to do this. It was a four and a half hour surgery and the doctor stated that the procedure went very smoothly. The nerves in his legs were showing much improvement and he is confident that this could be the last surgery he would have to do. Even though this is splendid news, the road to recovery will be a rough one. He can't bend down or do much of anything but sleep. He's been doing that and I've been trying to take care of him.
Last week, we got the final decision that Anthem will not be paying for the follicle scans that I did last year. Another fortunate thing too is that the claims department is looking into my other ones that were approved and maybe retracted. I really don't know what or how to feel about this. It's like we can never catch a break.
Labels: back surgery, husband, infertility, insurance, TTC
Tuesday, July 31, 2012
Inching Along....
The insurance fiasco is almost finished. Today, I sent in the last appeal letter and all dates of services are now being reviewed! I have the advocate looking to see what Anthem needs to approve these services.
That comes to another discussion that we maybe facing: Continue with the same office, continue with a different office or just give up. I'm about to get a second opinion to make sure I'm making the right decision. This office I'm at diagnosed me with Unexplained Infertility with Recurrent Pregnancy Loss. What happens if they tell me I need to do IVF and that doesn't work? What would happen if I did that procedure, go to another doctor and find out a diagnosis? I would be so pissed because I spent two years basically burning the money that could have been used to get me better and to try again. There is one forty-five minutes away and the one that we go to is about an hour and forty-five minutes away. Takes my insurance and everything.
I should have been doing this sooner but I was on the fence. I have been taking Red Raspberry Tea Leaves in a pill form to improve my lining. What is that you say? It's a natural herb that most women use to strengthen the uterus, promote blood circulation, and ease menstrual cramps. It's also used in the 3rd trimester to ease labor pains. Before you go jumping to the nearest herbal store to get some, there were lots of warnings to be aware of:
- Don't use it past ovulation! Very important that you start the regimen the day that you get your period and stop when you ovulate. Not only because it won't matter too much because it's passed the point where you may have conceived, but also because if you thicken your lining too much and it sticks, you could get a miscarriage because it's too thick! This is why trying to conceive (TTC) can be so tricky and take so much time to sustain a healthy pregnancy.
- Take what is instructed! If the bottle tells you to only take two a day, then take what is prescribed. You should only have up to 1,000mg of this stuff or you could have bad side effects.
- Don't take it with other fertility medication! Another big and important thing to consider. The reason why you should take it because if you use ART or use, say, Estradiol with it, you're going to overstimulate yourself. If you were going for an IUI, the doctor may cancel that procedure because of that reason.
- It may take a couple of months to work (or may not work at all)! I wish I could say this is the end all solution to having a healthy pregnancy (trust me, with all the crap that we've been through I wish I could say this is the case!) but every woman is different. It could help me but may not for some. When I looked up reviews, some say it could take five months to be effective.or it may not work for you.
- As always, speak to your doctor or RE to see if it's right for you!
I just started taking it and I can feel it working, blood flow wise. I really hope that this helps because Estradiol has so many side effects and makes me very sick sometimes. With Red Raspberry Tea Leaves, the only side effect that I've experienced was nausea. Because the hubby is having back surgery, so I'm taking this to prepare my body so when we're ready, my uterus is strong enough.
Labels: Estadiol, infertility, insurance, IUI, miscarriage, pregnancy loss, Red Raspberry Tea, TTC
Tuesday, July 3, 2012
Finally!!
Anthem has finally paid the IUI package! It included the sonograms, semen wash and the procedure, which totaled $640. It took most of the HRA account and only had to pay like $100. So, I only have about $500 left to pay so I can actually go back and do more procedures. Hopefully this will set precedence and no matter if we start next year, they won't be pulling this shit. I'm just so relieved that was taken care of and don't have to worry for the next time and that follicle scan was covered too.
I'm just hoping that the others are fixed very soon so we can get a credit that could hopefully be used for future treatments or to put in the housing account. We're still talking about going back, but we're having fun by ourselves. I think we're going to wait until next year because we want to go on a Disney Cruise and go to Universal Studios. He has been wanting to go to the Harry Potter part of Islands of Adventure but with everything that went on at once, just couldn't go down. Even though Disney is renovating, it won't be done for quite some time. We've never been on a cruise and it goes to the Bahamas. I think with all the hard work with getting this done, we can use that money to breathe just a little bit and go on a relaxing vacation to somewhere we may never go to once we have children.
Labels: Anthem, Cruise, Disney, Harry Potter, insurance, Islands of Adventure, IUI, TTC, Universal, vacation