I am so peeved with DH's insurance! First of all, I am very grateful we have insurance and I know so many people are suffering with illnesses and can't afford to go to the dr.
Anyway, we were hoping that DH's insurance would cover a portion of D's surgery. It was not technically a fertility treatment and could ultimately help prevent D from getting testicular cancer in the future. Well, they have decided that they will cover about $317 of the $14,000 surgery. OK, fine, I will deal with that, we'll tap into IVF savings and pay for it. This may cause us to cycle in June 2009 instead of March.
So, when DH was admitted to the hospital last week for the MRSA, I called his insurance within the 48 hour window to let them know he had been admitted. We get a letter today saying that they will not be covering DH's hospital stay because they did not receive any info from the hospital or DR. and it has been "denied for lack of information." Are you fucking kidding me?
He has MRSA, he was contagious, he had an open wound the size of a golf ball oozing on his stomach! I am so angry I could punch a wall!
Monday the battle is on, they should be scared of me, I'm going in with my guns blazing. I'm calling the Dr., the hospital and the insurance. I hope it all works out. I can not even imagine how much a 5 day hospital stay will cost us on top of D's surgery.
******************************************
In other fun news I had to go to Target today to get a gift for my cousin's baby shower on Sunday. I love buying baby stuff, I just wish it was for my baby.
I hope I get through the day with out crying.
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We've been TTC since 9/06 and DH has unexplained NOA. After 3 surgeries, including a failed mTESE and IVF we decided to move on to DS. We were blessed to get pregnant with 4 babies, but sadly I m/c'ed. 3 D-IUI's, 3 IVF's and 2 FET's and we're still trying to figure it out. I am going to be honest and open about my feelings; At times I may be whiney, annoying, complaining and depressing. We're just trying to heal and figure out what's next for us.
About Me
- theworms
- D and I have been together for 12 years and married 5. We thought starting a family would be a piece of cake, we were wrong. This is our journey to the family we have been praying, hoping, dreaming and wishing for. If you have any questions about unexplained NOA, sertoli cell-only pattern sperm or just want to chat please email me at theworms1022@gmail.com.
Our Journey So Far - 5 years and counting :(
*Met in October 1998
*Got Married in October 2005
*started TTC in Sept. 2006
2007
*Used at home fertility test, Fert.ell and it said I was fine and DH needed to see a Dr. (we thought it was wrong)
*1st SA in October = no sperm (we thought it was just a formality and it was me, we were wrong. D is so upset, comes from a long line of pro-creaters, youngest of 12 kids and we have 48 nieces and nephews, some of them great nieces and nephews)
*Praying it is a blockage
*Test for blocked tubes, cystocopy, no blockage November *Testicular biopsy in November = old Uro interpreted slide as Maturation Arrest (D also gets an infection)
*DH was on clomid and hcg injections for 3 months
2008
*meet w/ RE and have basic testing done and SHG
*Repeat SA February = no sperm
*in April Consult with MFI Dr. (one of the best in the country) Ran lots of tests on DH, everything is normal
*Interprets biopsy slide as Sertoli Cell-Only Pattern
*MFI Dr. recs. that DH have Orchiopexy (moving testicles further from body) and Varicocele Surgery (opening up veins) and he does in September (he also winds up in hospital for 5 days with MRSA infection)
*DH took 25 mg clomid from 11/08 to 3/09
2009
*Started BCP for IVF w/ICSI and mTESE on 1/31/09
*Added Lupron on 2/22
*Started Stimming 3/7 (150 units gonal F)
*Triggered on 3/17
*mTESE 3/18 = no sperm found (DH also gets another infection)
*decided to move forward w/ DS and purchased DS in July
*met with new RE in August
*CD3 b/w repeated 9/29/09
*HSG = all clear 10/5/09
*1st D-IUI, clomid, 50 mg for 5 days (11/12 - 11/16)
*ovridel trigger 11/18
*IUI#1 11/20
*beta 12/4 = big fat FAIL
*2nd D-IUI CD3 b/w u/s 12/9/09
*100 mg clomid 12/9 - 12/13
*Monitoring appt. 12/16 = 4 follies
*ovridel trigger 12/17
*IUI#2 12/19
*BFN 1/4/10
2010
*3rd D-IUI CD4 b/w u/s 1/11
*100 mg clomid 1/11 - 1/15
*Monitoring appt. 1/18 = 2 follies
*ovridrel trigger 1/19
*IUI #3 1/21
*beta 2/4 = BFN
* Moving Forward w/ IVF 1.5
* started BCP 2/12/10
* added Lupron 3/19/10
* started folgard, baby aspirin and dexamethazone 3/19/10 *started stimming for IVF 1.5 3/31 (150 units gonal F and 1 vial menopur)
*Triggered on 4/9/10
*ER 4/11/10, 22 eggs
*1st Fert Report 4/12/10, 17 mature, 15 Fertilized
*Day 3 Fert Report 4/14/10, 11 exactly where they should be and 4 stragglers
*ET 4/16/10, transferred 2 blasts
*4 expanded blasts frozen
*Beta #1 10dp5dt on 4/26/10, 168
*Beta #2 12dp5dp on 4/28/10, 448
*1st u/s 5w2d, it's twins :)
*2nd u/s 6w2d, lost baby 5/11/10
*3rd u/s 7w1d, lost other baby 5/17/10
* D&C 6/7/10
*RPL & clotting b/w show blood clotting disorder
FET
*7/1 - started BCP
*7/9 - hysteroscopy
*7/22 - add lupron, dexamethasone, folgard
*7/25 - last BCP
*7/31 - baseline and start E2V (intra-muscular 2 times a week) and lovenox (60mg)
*8/14 - b/w & u/s
*8/20 FET!!!
*8/29 Beta = BFFN
*9/2 WTF appt.
*9/29 cd 24 endometrial biopsy
IVF#2
*10/12 started provera
*10/23 added lupron, baby aspirin, folgard, dexamethazone
*10/26 last provera
*10/28 AF arrived
*11/1 baseline
*11/3 started stimming and lovenox
stims varied through out cycle, I was on gonal F and menopur
*11/8 intralipid infusion
*11/13 triggered
*11/15 ER - 11 eggs
*11/16 fert report 5 mature eggs, 5 fertilized
*11/18 day 3 fert report, all 5 exactly where they are supposed to be
*11/20 transferred 2 expanded blasts grade 1 and grade 2
*11/29 9dt5dt beta#1 - 149
*12/1 11dpt5dt beta#2 - 450
*12/13 1st u/s 6weeks 1 baby w/HB
*12/13 around 10pm started bleeding
*12/14 2nd u/s baby is gone m/c #3
FUCK!!!!!!
2011
*1/31 met with hematologist, ran lots of b/w
*2/14 follow up w/ hematologist, more b/w
i have disproportionate ratios in Von Willebrand Factor (tendency to bleed)
*2/15 CCRM phone consult
*2/27 started BCP for FET
*2/28 hysteroscopy
*3/8 met with RPL Dr., lots more bloodwork
*3/31 started meds for FET
dexamethesone, Lupron 10 units
*4/4 dropped to 5 units of Lupron
*4/9 started delestrogen .2ml
*4/28 transferred 2 expanded blasts
*5/6 8dp5dt BFP beta is 57
*5/10 12dp5dt beta is 262
*5/16 5w2d started bleeding, u/s showed 1 sac, beta is 1817
*5/23 6w2d m/c
more testing, no more answers
lots of bleeding 6/29, 7/1, 7/10 on and huge bleed on 7/15
7/22 hysteroscopy, 5 polyps removed
*Got Married in October 2005
*started TTC in Sept. 2006
2007
*Used at home fertility test, Fert.ell and it said I was fine and DH needed to see a Dr. (we thought it was wrong)
*1st SA in October = no sperm (we thought it was just a formality and it was me, we were wrong. D is so upset, comes from a long line of pro-creaters, youngest of 12 kids and we have 48 nieces and nephews, some of them great nieces and nephews)
*Praying it is a blockage
*Test for blocked tubes, cystocopy, no blockage November *Testicular biopsy in November = old Uro interpreted slide as Maturation Arrest (D also gets an infection)
*DH was on clomid and hcg injections for 3 months
2008
*meet w/ RE and have basic testing done and SHG
*Repeat SA February = no sperm
*in April Consult with MFI Dr. (one of the best in the country) Ran lots of tests on DH, everything is normal
*Interprets biopsy slide as Sertoli Cell-Only Pattern
*MFI Dr. recs. that DH have Orchiopexy (moving testicles further from body) and Varicocele Surgery (opening up veins) and he does in September (he also winds up in hospital for 5 days with MRSA infection)
*DH took 25 mg clomid from 11/08 to 3/09
2009
*Started BCP for IVF w/ICSI and mTESE on 1/31/09
*Added Lupron on 2/22
*Started Stimming 3/7 (150 units gonal F)
*Triggered on 3/17
*mTESE 3/18 = no sperm found (DH also gets another infection)
*decided to move forward w/ DS and purchased DS in July
*met with new RE in August
*CD3 b/w repeated 9/29/09
*HSG = all clear 10/5/09
*1st D-IUI, clomid, 50 mg for 5 days (11/12 - 11/16)
*ovridel trigger 11/18
*IUI#1 11/20
*beta 12/4 = big fat FAIL
*2nd D-IUI CD3 b/w u/s 12/9/09
*100 mg clomid 12/9 - 12/13
*Monitoring appt. 12/16 = 4 follies
*ovridel trigger 12/17
*IUI#2 12/19
*BFN 1/4/10
2010
*3rd D-IUI CD4 b/w u/s 1/11
*100 mg clomid 1/11 - 1/15
*Monitoring appt. 1/18 = 2 follies
*ovridrel trigger 1/19
*IUI #3 1/21
*beta 2/4 = BFN
* Moving Forward w/ IVF 1.5
* started BCP 2/12/10
* added Lupron 3/19/10
* started folgard, baby aspirin and dexamethazone 3/19/10 *started stimming for IVF 1.5 3/31 (150 units gonal F and 1 vial menopur)
*Triggered on 4/9/10
*ER 4/11/10, 22 eggs
*1st Fert Report 4/12/10, 17 mature, 15 Fertilized
*Day 3 Fert Report 4/14/10, 11 exactly where they should be and 4 stragglers
*ET 4/16/10, transferred 2 blasts
*4 expanded blasts frozen
*Beta #1 10dp5dt on 4/26/10, 168
*Beta #2 12dp5dp on 4/28/10, 448
*1st u/s 5w2d, it's twins :)
*2nd u/s 6w2d, lost baby 5/11/10
*3rd u/s 7w1d, lost other baby 5/17/10
* D&C 6/7/10
*RPL & clotting b/w show blood clotting disorder
FET
*7/1 - started BCP
*7/9 - hysteroscopy
*7/22 - add lupron, dexamethasone, folgard
*7/25 - last BCP
*7/31 - baseline and start E2V (intra-muscular 2 times a week) and lovenox (60mg)
*8/14 - b/w & u/s
*8/20 FET!!!
*8/29 Beta = BFFN
*9/2 WTF appt.
*9/29 cd 24 endometrial biopsy
IVF#2
*10/12 started provera
*10/23 added lupron, baby aspirin, folgard, dexamethazone
*10/26 last provera
*10/28 AF arrived
*11/1 baseline
*11/3 started stimming and lovenox
stims varied through out cycle, I was on gonal F and menopur
*11/8 intralipid infusion
*11/13 triggered
*11/15 ER - 11 eggs
*11/16 fert report 5 mature eggs, 5 fertilized
*11/18 day 3 fert report, all 5 exactly where they are supposed to be
*11/20 transferred 2 expanded blasts grade 1 and grade 2
*11/29 9dt5dt beta#1 - 149
*12/1 11dpt5dt beta#2 - 450
*12/13 1st u/s 6weeks 1 baby w/HB
*12/13 around 10pm started bleeding
*12/14 2nd u/s baby is gone m/c #3
FUCK!!!!!!
2011
*1/31 met with hematologist, ran lots of b/w
*2/14 follow up w/ hematologist, more b/w
i have disproportionate ratios in Von Willebrand Factor (tendency to bleed)
*2/15 CCRM phone consult
*2/27 started BCP for FET
*2/28 hysteroscopy
*3/8 met with RPL Dr., lots more bloodwork
*3/31 started meds for FET
dexamethesone, Lupron 10 units
*4/4 dropped to 5 units of Lupron
*4/9 started delestrogen .2ml
*4/28 transferred 2 expanded blasts
*5/6 8dp5dt BFP beta is 57
*5/10 12dp5dt beta is 262
*5/16 5w2d started bleeding, u/s showed 1 sac, beta is 1817
*5/23 6w2d m/c
more testing, no more answers
lots of bleeding 6/29, 7/1, 7/10 on and huge bleed on 7/15
7/22 hysteroscopy, 5 polyps removed
65 Books in 2011
1. Cresendo by Becca Fitzpatrick
2. Night Star by Alyson Noel
3. Wicked by Sara Shepard
4. Dead to the World by Charlaine Harris
5. Dead and Gone by Charlaine Harris
6. Awakened by P.C. & Kristin Cast
7. Lovers and Newcomers by Rosie Thomas
8. Love Letters by Katie Fforde
9. Insatiable,
10. When Lightning Strikes,
11. Code Name Cassandra,
12. Queen of Babble,
13. Queen of Babble in the Big City
14. Queen of Babble Gets Hitched,
15. Safe House,
16. Sanctuary &
17. Missing You by Meg Cabot
18. Maybe This Time by Jennifer Crusie
19. Seven Year Switch by Claire Cook
20. Conception Chronicles by by Patty Doyle Debano, Courtney Menzel and Shelly Sutphen
21. Notting Hell by Rachel Johnson
22. Metro Girl by Janet Evanovich
23. The Girl with the Dragon Tattoo by Steig Larsson
24. True Colors by Kristin Hannah
25. Star Island by Carl Hiaasen
26. River Marked by Patricia Briggs
27. Mini Shopaholic by Sophie Kinsella
28. Me by Ricky Martin
29. Size 12 is Not Fat,
30. Size 14 Isn't Either &
31. Big Boned by Meg Cabot
32. Anyone But You by Jennifer Crusie
33. The Girl Who Played with Fire &
34. The Girl Who Kicked the Hornet's Nest by Steig Larsson
35. The Castaways by Elin Hilderbrand
36. Water for Elephants by Sara Gruen
37. Dead Reckoning &
38. A Touch of Dead by Charlaine Harris
39. Practically Perfect by Katie Fforde
40. Smokin' Seventeen by Janet Evanovich
41. Sing You Home by Jody Picoult
42. Once Upon a Time, There Was You by Elizabeth Berg
43. Barefoot &
44. The Island by Elin Hilderbrand
45. Everlasting by Alyson Noel
46. Overbite by Meg Cabot
47. What Would Jane Austen Do? by Laurie Brown
48. Bossypants by Tina Fey
49. The Baby Trail by Sinead Moriarty
50. The Pact by Jody Picoult
51. Original Sin, A Sally Sin Adventure by Beth McMullen
52. Blue Bloods by Melissa de la Cruz
53. One Day by David Nicholls
54. Home Improvement: Undead Edition edited by Charlaine Harris and Toni L.P. Kelner
55. Heat Wave by Richard Castle
2. Night Star by Alyson Noel
3. Wicked by Sara Shepard
4. Dead to the World by Charlaine Harris
5. Dead and Gone by Charlaine Harris
6. Awakened by P.C. & Kristin Cast
7. Lovers and Newcomers by Rosie Thomas
8. Love Letters by Katie Fforde
9. Insatiable,
10. When Lightning Strikes,
11. Code Name Cassandra,
12. Queen of Babble,
13. Queen of Babble in the Big City
14. Queen of Babble Gets Hitched,
15. Safe House,
16. Sanctuary &
17. Missing You by Meg Cabot
18. Maybe This Time by Jennifer Crusie
19. Seven Year Switch by Claire Cook
20. Conception Chronicles by by Patty Doyle Debano, Courtney Menzel and Shelly Sutphen
21. Notting Hell by Rachel Johnson
22. Metro Girl by Janet Evanovich
23. The Girl with the Dragon Tattoo by Steig Larsson
24. True Colors by Kristin Hannah
25. Star Island by Carl Hiaasen
26. River Marked by Patricia Briggs
27. Mini Shopaholic by Sophie Kinsella
28. Me by Ricky Martin
29. Size 12 is Not Fat,
30. Size 14 Isn't Either &
31. Big Boned by Meg Cabot
32. Anyone But You by Jennifer Crusie
33. The Girl Who Played with Fire &
34. The Girl Who Kicked the Hornet's Nest by Steig Larsson
35. The Castaways by Elin Hilderbrand
36. Water for Elephants by Sara Gruen
37. Dead Reckoning &
38. A Touch of Dead by Charlaine Harris
39. Practically Perfect by Katie Fforde
40. Smokin' Seventeen by Janet Evanovich
41. Sing You Home by Jody Picoult
42. Once Upon a Time, There Was You by Elizabeth Berg
43. Barefoot &
44. The Island by Elin Hilderbrand
45. Everlasting by Alyson Noel
46. Overbite by Meg Cabot
47. What Would Jane Austen Do? by Laurie Brown
48. Bossypants by Tina Fey
49. The Baby Trail by Sinead Moriarty
50. The Pact by Jody Picoult
51. Original Sin, A Sally Sin Adventure by Beth McMullen
52. Blue Bloods by Melissa de la Cruz
53. One Day by David Nicholls
54. Home Improvement: Undead Edition edited by Charlaine Harris and Toni L.P. Kelner
55. Heat Wave by Richard Castle
Trouble Trying To Conceive Lingo
BCP = Birth Control Pills
Beta = Blood test for HcG (pregnancy hormone)
BFN = Big Fat Negative (on HPT)
BFP = Big Fat Positive (i.e. PREGNANT!)
CBEFM - Clear Blue Easy Fertility monitor
DE = Donor Eggs
DH = Dear Husband. Even when he's not being particularly dear.
DS = Donor Sperm
DX = Diagnosis
ER = Egg Retrieval (part of IVF)
ET = Embryo Transfer (last step of IVF)
FET = Frozen Embryo Transfer
Follies = Follicles or Eggs
HPT = Home Pregnancy Test
HSG = x-ray of Uterus and Fallopian tubes done by inserting dye through the cervix.
ICSI - intracytoplasmic sperm injection – used with IVF, especially in cases of Male Factor Infertility
IF = Infertility
Injectibles = see "Stims"
IUI = Intrauterine Insemination
IVF = In Vitro Fertilization
Lap = Laproscopy
M/C – miscarriage
MFI = Male Factor Infertility
mTESE = microdissection Testicular Sperm Extraction
NOA = non-obstructive azoospermia
OHSS = Ovarian Hyperstimulation Syndrome
PCOS = Polycystic Ovary Syndrome
PIO = Progesterone in Oil
POAS = Pee on a stick (i.e. taking a HPT)
PUPO = Pregnant Until Proven Otherwise
RE = Reproductive Endocrinologist
SA = Semen Analysis
S/E = Side Effects
Stims = follicle stimulating drugs
TTC = Trying to Conceive
TTTC = Trouble Trying to Conceive
TI = Timed Intercourse
U/S = Ultrasound
Beta = Blood test for HcG (pregnancy hormone)
BFN = Big Fat Negative (on HPT)
BFP = Big Fat Positive (i.e. PREGNANT!)
CBEFM - Clear Blue Easy Fertility monitor
DE = Donor Eggs
DH = Dear Husband. Even when he's not being particularly dear.
DS = Donor Sperm
DX = Diagnosis
ER = Egg Retrieval (part of IVF)
ET = Embryo Transfer (last step of IVF)
FET = Frozen Embryo Transfer
Follies = Follicles or Eggs
HPT = Home Pregnancy Test
HSG = x-ray of Uterus and Fallopian tubes done by inserting dye through the cervix.
ICSI - intracytoplasmic sperm injection – used with IVF, especially in cases of Male Factor Infertility
IF = Infertility
Injectibles = see "Stims"
IUI = Intrauterine Insemination
IVF = In Vitro Fertilization
Lap = Laproscopy
M/C – miscarriage
MFI = Male Factor Infertility
mTESE = microdissection Testicular Sperm Extraction
NOA = non-obstructive azoospermia
OHSS = Ovarian Hyperstimulation Syndrome
PCOS = Polycystic Ovary Syndrome
PIO = Progesterone in Oil
POAS = Pee on a stick (i.e. taking a HPT)
PUPO = Pregnant Until Proven Otherwise
RE = Reproductive Endocrinologist
SA = Semen Analysis
S/E = Side Effects
Stims = follicle stimulating drugs
TTC = Trying to Conceive
TTTC = Trouble Trying to Conceive
TI = Timed Intercourse
U/S = Ultrasound
10 comments:
Definitely resubmit your claims...and appeal the first one. I think they always try to deny once...but even if they found some IF reason to deny the surgery...the MRSA hospitalization HAS to be covered.
I hate insurance companies. I just got a bill for 650 bucks for some of hubbys genetic testing that was denied because they....completely screwed up his name on the claim.
I sent a nice letter with a copy of his insurance card and politely reminded them how important SPELLING is.
Give it another try.
Oh, and I'm waiting until June 2009...so maybe we'll be cycling around the same time.
How terrible! It's amazing the things they think they can get away with! What a lame-ass excuse!
Hopefully you thoroughly frighten them and they cover something, and not just $300.
Wow! what a fiasco. They should be scared of you. I'd be so ticked off too. I hope everything works out for the best e.g. everything gets covered.
This sucks. I really hate insurance companies.
As if life isn't hard enough, now you have to wade through this crap. Good luck.
I used to do that exact thing for an insurance company. Denied for lack of information doesn't mean it was denied really. It means they called the hospital to find out the details and try to approve it and the hospital or doctor didn't call them back. Usually the hospitals will eventually give up the info, but often not within the time period that the insurance company has to send out that letter. You can also submit the medical records if needed, but usually the hospital will. If I can answer any questions about it, feel free to email me. I had to send those stupid letters for a few years. Or if they continue to deny it and you want to appeal it, I can give you some tips on that too.
(ICLW)
That absolutely sucks. I hope you are able to get it resolved. From the comments here, it sounds like you should be able to.
Best wishes for getting through the shower today. I cried the entire way home from one last year -- it definitely sucked.
(HUGS)
Hi i have been following your blog with gr8 interest, i would like to become a follower im just not sure how to do it ..Please help..
im in the UK and we dont deal with insurance companies the way you have too, we have the nhs and get free treatments with that, i also work for the nhs. I hope ur hubby is recovering from the MRSA ..nasty little bug that it is !
WTF is RIGHT!!! I hate insurance...Again I'm glad we have it too. But they can be such SNAKES!!! I hope everything works out ok...Keep fighting. They usually give in. Just don't give up.
I got your message my the way...heheh...Thanks for the award and I have updated my blog. Thanks for keeping me dilligent.
:)
Christine
Gotta love insurance! I hope you can get it resolved.
I can't believe that they are pulling that crap. I really hate insurance companies. They should pay for the surgery and they should pay for his recent hospital stay. No doubt. I hope you get it all covered.
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