Friday, February 25, 2011

All Clear!

The much dreaded hysteroscopy and mock embryo transfer is over, and the conclusion is - Fibroids not in uterine cavity, and, in fact my uterus looks smooth, pink and lovely.  That's right folks, we are go for IVF, do not pass go, do not collect and money whatsoever because the fertility doc has taken it all.

On to a complaint about insurance.  DH and I were so excited to find out that this last procedure would be covered by our insurance due to it being for fibroids and not just infertility.  It is such a shock to have anything covered at this point, so obviously there was rejoicing, a toast, and some loving smooches over the little bit of money we might not have to scrounge for.

Now, fast forward to the actual day of the procedure.  There we are having a lengthy argument with the office billing staff over the coding for the hysteroscopy.  She is insisting that they can't put it down as uterine fibroids because no fibroids were found in the uterus:

Me: But, the test was done because they couldn't determine how big the fibroids are or if they were pressing on the uterine wall.  So, the test should be covered.
Evil staff lady (ESL): But the conclusion of the test is that no fibroids were found, so we can no put down uterine fibroids as the purpose.
Me: But, we only had the test because of the fibroids, just because the outcome was that they aren't pressing on the uterus doesn't change that.
ESL: But, no fibroids were seen, so we can't put that down. 
Me: But, just because the test was negative, why does that change the purpose of the test?
ESL: We can't put that fibroids were found in the uterus when no fibroids were seen.
Me:  I don't think you are understanding me.  I 'm not asking you to say that fibroids were seen in the cavity today, I'm just asking you to report to the insurance company that the test was done to determine the extent of the uterine fibroids in my lining, so they will code it properly and cover it.  It shouldn't matter whether it was seen that they were pressing on the uterine cavity or not.
 ESL:  I'm sorry, no fibroids were seen today, so we can not bill for uterine fibroids, and we can not use "rule out" as a reason for the test.
DH: So, if my doctor thought I had pneumonia, and he did a test for pneumonia but it came back negative, you are saying your couldn't bill the test as having been for possible pneumonia?
ESL: Well, that test would probably take a day or two to come back, so on the day it was billed there would be no conclusion and you could bill it for pneumonia.
Me: (Hallucinating about the many ways I could cause bodily harm to this woman).  Please tell me you see how bizarre this all sounds...
ESL: Well, I'm sorry you feel that way, but as the conclusion today was that there are no fibroids in your uterine cavity, we can not put uterine fibroids on the bill to the insurance company.

It took every ounce of my power, and the fact that I was doped up on pain killers from the procedure, not to go completely ape sh*& at this point.  I really, didn't think DH would survive the conversation, but we paid and made it to car with no major outbursts or daggers thrown.

Needless to say, it was not a great morning.  Oh, and I don't care what they say, the test hurt like hell.  My doc, sweet as he is, says I must have a very sensitive cervix - my thoughts: I would like to know how he would feel if I stuck three metal probes and a camera up his bits without even local anesthesia .

Image for yesterday's efforts:


  1. Oh my god, how annoying. It's like a sketch comedy or something. She can't be for real. But yay for no fibroids and IVF!

  2. You've got to be kidding me about the office lady...a testament to your strength by not slapping her :)

    BUT yay for no fibroids!

  3. OH MY GOD. I was banging my head here before I even saw your diagram. I am sorry you are having to deal with such incompetence! I found myself thinking, before I got to the part about pnemonia, "you mean, if someone has a head CT to check for a possiblle brain tumor, and there is no brain tumor, insurance won't cover the test?" Completely ridiculous! I think they need to adopt a mechanics attitude. When we bring in a tire to be fixed, and they can't find the leak, therefore they don't fix anything...they don't charge us anything either! Grrr. I'm Grring for you. But, great news that everything looks good.

    And, on another note, I fear that Blurb may becomg addicting. I'm feeling the urge to make vacation photo books now! Too bad I bought an actual leather album on my honeymoon that I really should use instead!

  4. Sadly, this was no comedy act - just my life.

    We were also warned that if we didn't pay the upfront/self-pay cost, and the insurance company denied the claim (which they would without the listing for uterine fibroids), then we would be charged the full amount without the self-pay discount. So we were basically being told to pay up and shut up or prepare to be punished. :(

  5. Okay, I'd like to punch that lady! That is so ridiculous!
    But yay for all clear and a nice uterus! Woot!

  6. So very happy that you are fibroid free but holy cow... the nerve of that lady! Crazy! That makes NO sense at ALL.

    Yay for IVF! I'm so jealous that you have already started the birth control pills... I can't wait to start mine and get this show on the road! :)

  7. UGH! I wnt to punch that woman for you!!! How ridiculous.

    YAY for the all clear though and for IVF :)

  8. wow. love the image. so appropriate for moments like that.

    on a positive note though, yay for progressing to ivf (well, not yay really, but yay given the situation).

  9. Uh... when I had a hysteroscopy, they knocked me out. And that ESL - would have had me screaming. That's wack.

  10. I think I would've punched her. Good for you for maintaining composure, but I think they need a more empathetic person working at the insurance desk. That's total crap that she wouldn't code it properly. Maybe you can ask your doctor to intervene, seems like she was simply on a power trip.

  11. That is sucky. Pure and simple. I have been told something similar when i asked if I should have a Lap done to check for Endo. The insurance company said that if Endo was found, the procedure would be covered...if there is none - we pay. So stupid.

    Oh and thank you for the Clomid! I got it and plan to figure out when I will use it in the near future. Lovely surprise. I think I like getting mail and that we should start sending letters and cards to each other!

  12. Happy ICLW! and I think both you and your uterus deserve a gold star for dignity and grace under extreme provocation....every luck and love for the upcoming IVF! xxxxxxxx

  13. What the fuck? They can't put down fibroid investigation?!

    Man, it isn't your head that you should be banging.