Friday, July 07, 2006

Insurance Saga Installment Number 7,135

The saga continues. Yesterday I got second-notice bills for the HSG from the OB and the hospital. That was enough to spur me to get on the phone today. First I called the insurance. The lady I talked to confirmed what someone had told me earlier: the HSG was coded by my OB as a treatment for infertility. The insurance only covers diagnostic testing, hence the "treatment" was denied coverage. I explained to her that it was not treatment, that it was a test. Then I requested that she transfer me to someone who could tell me how the OB is supposed to code it to get it covered. She said no one in their office does coding so no one there can tell me how to code it differently. Bascially, she said, it's up to the doctor to code it correctly and they make decisions based on the coding. So I asked to speak to her supervisor who is, conveniently, out until Monday. That didn't deter me from leaving a long (hopefully polite-sounding) message requesting a call back.

Then I called the OB's office and (SURPRISE) got the voice-mail for the billing department. I just left my name and number and asked for a call back. I won't hold my breath too long on that one.

Then I covered my third base by sending a message for my BIL to call me. He's the one who told me to fight the insurance in the first place. I'm hoping he can tell me who in his office does coding stuff and maybe she can tell me the right code. Since he used to be an OB I'm keeping my fingers crossed that maybe someone there knows. If that doesn't work out, plan B is actually to call the specialist's office and see if someone in their billing department will take pity on me and give me access to these super-secret codes. But I'm holding that plan in reserve if none of the other 3 work out.

Egads, I hate all this insurance stuff. But I am more determined than ever to get it straightened out by someone. At least it fills the time while waiting for the egg to drop.

1 comment:

Lorem ipsum said...

Psst... it's not a super secret. They're called ICDM-9 codes. Here's a menu...

http://icd9cm.chrisendres.com/index.php?action=child&recordid=5683

And good luck!