Float Like A Butterfly, Sting Like A Bee!
Well, sort of. I’m still waiting for the paper work but…
As many of you know, I have been having major problems with my insurance company since September of 2008. The latest round consisted of them sending my doctor the most egregious fax, stating that they could not even consider my latest request for IVF authorization because of my usage of donor sperm!
As you know, I was completely devastated by the decision and have spent the last couple of months strategizing with my doctor on how best to fight the appeal. This is on top of the months I spent doing IUIs, in effort to meet their ‘medical standards for infertility.’
On Wednesday, I submitted an extensive appeal letter, chronicling every phone call and correspondence with them, essentially building my case.
Here’s an excerpt from my appeal letter:
“Your most recent fax explaining the denial decision states the following: ‘member was denied IVF with ICSI and donor sperm on 2/09. Because I still cannot approve the request due to the donor sperm, I cannot accept this request.‘ I am very confused by the reason given for my denial. I have undergone 10 IUI cycles and 1 failed IVF cycle in my effort to become pregnant over a two year period. According to my understanding of your medical policy, I have met the medical requirements for an infertility diagnosis and, therefore, should be eligible for IVF coverage under my policy. I would like my case reviewed, my denial overturned, and my request for IVF authorization to be approved.
…
Please note that I am also filing a grievance with the state’s outside reviewer office because I feel as if my treatment via phone, letter and in deed on your part has been confusing, contradictory, inconsistent and, discriminatory to women who ‘don’t have access to donor sperm’, which is often the case with women in same sex relationships.”
Since Wednesday, I have spoken to several angels(!) at the state’s medical reviewer’s office and they also agreed to review my case because they too suspected that there was some same-sex discrimination at play.
By the grace of God today, I got a call from my grievance officer at my insurance company, who is a really a nice guy at heart, and he told me that he was confident that they would issue the IVF authorization after all. He also said that he wished me the best and that he was ‘really pulling for me’ and I just started to cry. I could not even speak. Frankly, I did not think that I would ever see this day.
I am so psyched!
Well, my new plan, which is still the same plan I had on my birthday, is to proceed with estrogen priming towards mid-to late April and to start my next IVF cycle on May 2nd. But the difference now
is that someone else will be footing the bill.
Thanks to all of you who routed for me and offered to pummel those bastards. You got me through it.
We did it!
Well, you are just a heroine. It’s that simple. Good for you for fighting. I’m proud to know you (in an online kind of way!). And thank god the decision will be overturned!!! Yay. Yay. Yay.
1WHOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOHOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
2That’s awesome. My fingers are still crossed for you because I don’t trust those bit#$%es as far as I can throw them.
I am impressed with you arse-kickadge, though. Woo!
3Way to stick it to them!
4WOOT WOOT!!! That is the BEST news I have heard in FOREVER!
I am SOOO excited for you, and I hope those asstards get what’s coming to them (and you get what’s coming to you – those IVFs that you should have been approved for long ago!).
5I’m glad to hear that the insurance company is finally doing the right thing. I hope the next few week fly by and you can get started on the IVF cycle that I know you have been wanting to do for so long now.
6You are fierce! I am so proud of you. What an inspiration you are! Good luck with everything. xo
7i sincerely hope that this will be such a smooth process for you. you have been taken through the ringer, and i just know that you will be victorious!
i’m over here rooting for you.
8fantastic news!
9battles with insurance companies are tough and you did a GREAT job, sweetie!
Rock on! I’m dancing like Snoopy! I HATE insurance companies. Glad to see you overcome that hurdle!
10Any news?
11No, no news yet but I will keep you posted. And I have my fingers and toes crossed.
12That is amazing news! Every battle won against an insurance company is a win for us all! Congrats.
13Waiting to hear more. So glad that got resolved finally. You rock.
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