What did I win??? I won my battle with the insurance company!!!!!! <-- me doing the happy dance! *LOL*
If you've read my previous posts, you know the what happened. If not, here's a quick recap....
I had been seeing an endo for a few years, being treated for PCOS, and luckily my insurance was covering it (had to fight them a few times when they flagged it infertility and denied the claim, but just had to have my doc send the records showing it wasn't for infertility and they always paid it). Then a little over a year ago I went to my endo and he did the whole big lab workup and then saw some potential problems and did an endometrial biopsy. Anyway, when the claims came back from the insurance they were all denied. Completely denied, not a cent paid. So, after weeks of arguing on the phone with the insurance and the doctors office, I went to my HR department at work to find out how to file a formal appeal. It took forever, and then the first appeal was denied. They said if I still didn't agree with it, I could file an appeal of the denied appeal (sounded stupid at the time, but now I'm glad I did it!). So, I spent another few months gathering every article and study I could find showing that there was benefit to treating PCOS even if you weren't trying to get pregnant. I gathered it all up, wrote a long letter about why I thought it should be covered, and sent it all in again.
Ok, fast forward to today. Now a little over a year later....I get a letter in the mail. It has new revised claim forms, and IT HAS ALL BEEN COVERED!!!!!!!!!!!!!! (ok, well, they covered their 80% of it, which is what I wanted). They are going back and paying the past claims, and will cover them going forward (still as long as it's not for infertility). Ok, I just have to do the happy dance again. *LOL*
Thank you to everyone who gave me the advice and encouragement to fight for what I felt was right!
Congrats! That is great news! Good job and following through with that! Your dedication PAID off !
__________________ Kate (29) To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts. DH-Neil (33)
To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts. Married: December 28, 2002 2 furbabies - Q and Zia (They are Yorkies To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts. ) Dx w/ PCOS - 2003 Meds: Metformin 1700mg a day HSG 08/16/06 - All CLEAR! TTC again...
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That's terrific! Congrats! I admire your persistence!
__________________ Me- Melanie, age 31, DH- age 35
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Congrats! I am hoping that the lab bill I got today was just a mis-filing of insurance, and that my company won't fight me once it's correctly submitted. Thanks for the hope!
I won!!! I won!!! *doing the happy dance* 
<-- me doing the happy dance! *LOL*
I'm very happy for you Jessy!!
