Friday, February 22, 2013

Wading through it-

We got our new insurance cards the other day. FINALLY. And I had a nice long conversation with my insurance today.

First of all, a quick rant. Our local hospital went on a merging spree last year. They merged with the other local medical facility, they now own the labs, the x-ray place, the pediatrician's office, etc... It's unsettling. This merger means that the lab is now theirs, and not independent- it is billed through the hospital. For some reason (going to say the merger's grasp) my PCP now runs it's lab work through... yeah, the lab here in town. And NOT Labcorp, like they used to. Any lab work I get done at my PCP's office is supposed to be covered 100% after my office co-pay... unless it's billed through a hospital. In this case, it gets ran as part of my deductible with a high co-pay.

Guess who got an $83 bill for blood work ran in December, even though she shouldn't have owed a dime? This girl! I'm a little peeved.

I called my new insurance and it works the same with them. Any lab work ran through the "hospital" isn't going to fall under that 100% coverage. So I have to let all my doctors know they either have to give me a lab slip for another lab, or I'm going to find another doctor. V's pediatrician's office is already on my short list because they are giving me a really hard time about just giving me a damn lab slip. They want me to just go to their lab... you know, the one they own. Ahahahah, no. I'll find another doctor first. This also means I now have to drive 30 minutes (to the closest Labcorp) for any and all blood work. I can live with that, but it frustrates me. The lab here was 5 minutes away, getting it done in my PCPs office was even better since I was already there... but I'm going to do what I have to.

I know it's not that bad. I'm being whiny. Wah wah wah- I'm just really annoyed. And I'm frustrated that I got billed for this without knowing it was going to be ran different. My PCP ran my stuff through Labcorp in July, then suddenly in December they started using the local lab again? Mmmhmmm. Yeah, that doesn't seem weird. at. all.

Aside from that I asked about progesterone coverage. I need pre-authorization for PIO (coverage would be 25%) or Crinone ($70 a month, which isn't that bad). I think it's ridiculous that I'll need pre-authorization though. Which could get denied, and would take 3 days to go through. These are the two options we know would be best. I'd prefer Crinone, but if I start bleeding I'll have no option but to switch to PIO.

For generic Prometrium (I didn't know there was such a thing, the lady told me it's just called 'progesterone') it's $40- BUT I don't know if there's a limit on that for dose, or how much they consider a months worth. No clue about pharmamay compound progesterone coverage, but it doesn't look good.

So that was both enlightening and frustrating.

I'm still super sick and exhausted. I haven't been exercising, but I did make chocolate chip cookies yesterday. That was probably a mistake. On that note, I'm going to call it a day. I'll probably post about my weigh-in over the weekend.

Oh, and I'm like 9dpo now. Not very hopeful with how sick I've been, but we'll see. I'll probably start testing over the weekend since I have a bunch of cheap tests that came with my OPKs.


Celia said...

Peter needed an u/s and if I could have found a stand alone ultrasound person it would have been 30 dollars. I called and called and CALLED. I spent two weeks looking in my spare time. NOPE. Instead we paid hundreds for the exact same service at a hospital. I was so aggravated. At least Peter peed on the poor guy. REVENGE. WE WILL HAVE IT.

Celia said...

And not to be all FALSE HOPE! Here have some! But remember, our lucky cycle was the one where I was sick as a dog and all the sudden barf weight loss shocked my body into ovulating.

AnotherDreamer said...

Oh Celia, thank you for the ultrasound story LOL! And yeah, I know there's still a chance... I'm so pessimistic though, you know how it goes :)

Stinky said...

It sounds like such a bloody minefield - once you think you have the system down pat, it all changes without warning? Rude.

Hope the 'sickness' is on its way out the door (along with the RedBitch!! but lets hope she doesn't even get her foot in the door)