So after 37 emails back and forth (gmail counted for me), and three phone calls, I think we have the insurance situation handled for the moment. I got a lot of assurances that included phrases like: "delay in billing," "readjust some of the balances," "apply more of an adjustment," and "credit will be returned." I'm glad I insisted on it getting escalated until I got an answer. This part of fertility treatment is no joke - it's almost like a full time job keeping it all straight.
For the moment, things are still going back and forth between the insurance and clinic which I was told could take another 30 to 60 days. In the meantime though no payment is due while they hash it out. There's still a fat chance we may owe a chunk because the benefits did max out sometime in the fall, but it may not be as steep as originally thought.
In other news, nearly as important, I recently discovered quesadillas. This is definitely a life enhancing discovery.
Thursday, February 28, 2019
Monday, February 25, 2019
Upcoming bday blues
I'm sure I'm not the only one to experience birthday blues. I feel pressure to celebrate and make it awesome and worthy of being posted on social media. Sometimes I don't feel like making it into a big deal or that I've reached whatever milestone I thought I would have accomplished by said birthday.
By my friends and family I want to be celebrated and pampered and the same time I hate surprises and don't want anyone to feel obligated to do anything. It's hard to know what I want which means it's hard for them to know what to do. Then I try not to resent them for not living up to my unrealistic expectations.
In past years I came up with the idea to take a short trip around my birthday. We did Philadelphia one year, Chicago another, Niagara Falls once. All short trips, usually about two or three nights. The perfect amount of time to get away, feel like I've done something special, taking control of the day while easing off the burden from my loved ones to plan something incredible.
Last year we didn't go anywhere because of the pregnancy and subsequent miscarriage. This year my birthday is on a Friday and travel doesn't fit with our work schedules. I thought I made it clear to my husband what I want but from his responses and reactions I don't think I did, and it bums me out that it's a point of contention. I get that planning and gifting isn't everyone's strong point and I'm not only asking him to go outside his comfort zone but I'm also expecting him to completely change who he is and that's just unfair to us both.
Thirty five feels like a big number. Youth is officially over. I'm no longer in the 18-34 age range. It's officially as far away from my 20s as it is close to my 40s. AMA gets stamped on every OB chart, should I be so lucky to get to that point. Yet it's not even middle age. I don't feel old. I just no longer feel young. I try not to compare myself with people around me the same age. I try not to think that I've "wasted" nearly five years on being in limbo trying to build a family, feeling stuck career-wise, financially, and in nearly every aspect of life because of fertility treatments and their failures.
I feel that it's incredibly entitled to feel glum or complain about something as simple as a birthday and/or its celebration. No one owes me anything and I'm incredibly lucky to be turning a year older. So my goal for the next few weeks is to focus on gratitude and remind myself of the accomplishments and blessings we do have.
By my friends and family I want to be celebrated and pampered and the same time I hate surprises and don't want anyone to feel obligated to do anything. It's hard to know what I want which means it's hard for them to know what to do. Then I try not to resent them for not living up to my unrealistic expectations.
In past years I came up with the idea to take a short trip around my birthday. We did Philadelphia one year, Chicago another, Niagara Falls once. All short trips, usually about two or three nights. The perfect amount of time to get away, feel like I've done something special, taking control of the day while easing off the burden from my loved ones to plan something incredible.
Last year we didn't go anywhere because of the pregnancy and subsequent miscarriage. This year my birthday is on a Friday and travel doesn't fit with our work schedules. I thought I made it clear to my husband what I want but from his responses and reactions I don't think I did, and it bums me out that it's a point of contention. I get that planning and gifting isn't everyone's strong point and I'm not only asking him to go outside his comfort zone but I'm also expecting him to completely change who he is and that's just unfair to us both.
Thirty five feels like a big number. Youth is officially over. I'm no longer in the 18-34 age range. It's officially as far away from my 20s as it is close to my 40s. AMA gets stamped on every OB chart, should I be so lucky to get to that point. Yet it's not even middle age. I don't feel old. I just no longer feel young. I try not to compare myself with people around me the same age. I try not to think that I've "wasted" nearly five years on being in limbo trying to build a family, feeling stuck career-wise, financially, and in nearly every aspect of life because of fertility treatments and their failures.
I feel that it's incredibly entitled to feel glum or complain about something as simple as a birthday and/or its celebration. No one owes me anything and I'm incredibly lucky to be turning a year older. So my goal for the next few weeks is to focus on gratitude and remind myself of the accomplishments and blessings we do have.
Sunday, February 17, 2019
Insurance
Last week I was hit with the news that we have nearly $9000 of pending claims that were denied that we may be responsible for. I didn't understand what was going on since I've been on top of the bills and there was no indication of this on any of our statements, nor was it mentioned when I called in December making sure our account was clear in prep for the next FET.
In August we did IVF 8. Prior to the cycle we got pre-authorization and got the all clear. In December, when we were getting finances ready for the next FET, we were told we had exhausted our benefits. We were expecting as much and knew we would have to pay for the FET out of pocket. I verified our account had no other outstanding balance (it did not) and I decided to make a pre-payment for our FET to get the tax credit for 2018.
Turns out that our Aug claims weren't submitted until much later than the cycle - closer to Nov/Dec. When we received the notification in Dec about our benefits being maxed out, it was actually notification of our Aug claims being denied though no such wording was used. The pre-payment for the FET was then disbursed among all the open/denied claims and the $9k is the remaining amount.
To say I was livid is an understatement. I was so, so, so upset. First, no one bothered to tell us what was going on. We would still be in the dark had I not reached out the them with a question. I got a Feb statement for $1100+ and I emailed the financial counselor, confused, since our account was clear in December. She said she'll look into it and get back to me. I followed up FIVE days later and she said she's still looking into it. Later that day I got the shocking news that not only do we definitely owe the $1100+ but there is a whopper of a bill coming up because of all the denied claims. I asked about the prepayment and she said it's gone, disbursed among the open claims. I followed up with four additional emails in quick succession asking WHAT THE HELL in various ways, pressing send before I fully formulated the thoughts to try to get her before she left for the day.
The next day I felt my heart racing. I called the doctor taking my doc's patients while she's on maternity leave. I left a message and said I don't want to over react but I also don't want to under react if this is something that needs to be checked out. Doc called me back a few min later and as we were talking I started sobbing. I said I wasn't sure if I should go to urgent care or try to get in with my PCP or what but I'd rather feel silly for coming in rather than regret ignoring something important. She offered me to come in to see her so that's what I did. My blood pressure was in the 160s, my pulse in the 90s, and I couldn't stop sobbing. The doctor was so kind and patient and understanding. Through sobs I explained about the unexpected billing issue. I also shared my incredible fear of miscarrying again, especially in a traumatic way like last year because that had also been on my mind. BP was checked again, it was lower in the 140s. Then she went to the financial office to try to get some answers. In the old clinic the doctor would never get involved in the finances. She got the financial counselor to come talk to me to try to explain what's going on, but more importantly to promise to get a supervisor involved and get back to me with answers.
Then she listened to my heart for a while and said she couldn't hear a skipped or missing or extra beat like what I was describing. She said she can order an EKG for me if that's what I wanted. Toward the end of the appointment I was feeling better and said I will skip the EKG but follow up with the pcp if I felt the need. She recommended doing things to help me relax, like massage, exercise, music, etc.
I'm normally a rational, logical person. I've had a few instances in the past where my anxiety got the better of me (basically right around my husband's varicocele surgery where I couldn't stop thinking worst case scenarios), but for the most part I feel like I have it under control. When it starts manifesting in a physical way is when I start freaking out. Having something bother me that I don't address starts compounding (in this case, fear of mc) and then when there's a trigger I wasn't expecting (in this case, the billing situation) it just blows up. It's easy for me to say that now, a few days later, because hindsight is 20/20. But at the time it felt like the sky was falling and I was drowning. I am lucky the doctor didn't dismiss me, took the time to see me, and gave me the time I needed to get through it. I am extremely grateful.
Toward evening I had mellowed out significantly and my blood pressure was back to normal and so was my pulse. The next day I tried doing my own research about what we owe. While waiting for the supervisor from the clinic to call me back, I called my insurance. It sounds like yes we did indeed max out our lifetime fertility benefits. Our Aug claims only had about $900 covered and the rest of the cycle was not. For some reason the clinic didn't submit the claims until December which is why we only received notification at that point. I don't know why we weren't told about the pending/denied claims earlier. I don't know why we weren't told about disbursement of the pre-payment for pending claims. The insurance person went over all the claims that we may owe that are still pending.
One piece of surprising news in all this: while on the phone with insurance, I was told that the Aug - Dec claims were denied but one of the claims submitted in January was covered. Huh? Thanks to some policy change that we didn't know about or realize happened, turns out the plan we signed up for was slightly different than last year and that change resulted in an entirely new plan which means that as of 1/1/19 our lifetime maximum for fertility benefits has been renewed. What!!!!! I didn't even know that was an option!
So we're still on the line for thousands of dollars until we hear otherwise but hopefully having a renewed lifetime max will mean that we don't have to put anything on hold. I'm still very upset with the clinic for screwing up our billing, but I'm holding out for the supervisor and give her a chance to fix it before going nuts on them. And I've also learned not to let things fester. If something is bothering me, I need to take care of it. I thought I was managing fine -- I wasn't crying, I wasn't actively depressed -- but clearly I was in denial that something was bothering me. I will need to be more aware in the future to prevent another meltdown.
In August we did IVF 8. Prior to the cycle we got pre-authorization and got the all clear. In December, when we were getting finances ready for the next FET, we were told we had exhausted our benefits. We were expecting as much and knew we would have to pay for the FET out of pocket. I verified our account had no other outstanding balance (it did not) and I decided to make a pre-payment for our FET to get the tax credit for 2018.
Turns out that our Aug claims weren't submitted until much later than the cycle - closer to Nov/Dec. When we received the notification in Dec about our benefits being maxed out, it was actually notification of our Aug claims being denied though no such wording was used. The pre-payment for the FET was then disbursed among all the open/denied claims and the $9k is the remaining amount.
To say I was livid is an understatement. I was so, so, so upset. First, no one bothered to tell us what was going on. We would still be in the dark had I not reached out the them with a question. I got a Feb statement for $1100+ and I emailed the financial counselor, confused, since our account was clear in December. She said she'll look into it and get back to me. I followed up FIVE days later and she said she's still looking into it. Later that day I got the shocking news that not only do we definitely owe the $1100+ but there is a whopper of a bill coming up because of all the denied claims. I asked about the prepayment and she said it's gone, disbursed among the open claims. I followed up with four additional emails in quick succession asking WHAT THE HELL in various ways, pressing send before I fully formulated the thoughts to try to get her before she left for the day.
The next day I felt my heart racing. I called the doctor taking my doc's patients while she's on maternity leave. I left a message and said I don't want to over react but I also don't want to under react if this is something that needs to be checked out. Doc called me back a few min later and as we were talking I started sobbing. I said I wasn't sure if I should go to urgent care or try to get in with my PCP or what but I'd rather feel silly for coming in rather than regret ignoring something important. She offered me to come in to see her so that's what I did. My blood pressure was in the 160s, my pulse in the 90s, and I couldn't stop sobbing. The doctor was so kind and patient and understanding. Through sobs I explained about the unexpected billing issue. I also shared my incredible fear of miscarrying again, especially in a traumatic way like last year because that had also been on my mind. BP was checked again, it was lower in the 140s. Then she went to the financial office to try to get some answers. In the old clinic the doctor would never get involved in the finances. She got the financial counselor to come talk to me to try to explain what's going on, but more importantly to promise to get a supervisor involved and get back to me with answers.
Then she listened to my heart for a while and said she couldn't hear a skipped or missing or extra beat like what I was describing. She said she can order an EKG for me if that's what I wanted. Toward the end of the appointment I was feeling better and said I will skip the EKG but follow up with the pcp if I felt the need. She recommended doing things to help me relax, like massage, exercise, music, etc.
I'm normally a rational, logical person. I've had a few instances in the past where my anxiety got the better of me (basically right around my husband's varicocele surgery where I couldn't stop thinking worst case scenarios), but for the most part I feel like I have it under control. When it starts manifesting in a physical way is when I start freaking out. Having something bother me that I don't address starts compounding (in this case, fear of mc) and then when there's a trigger I wasn't expecting (in this case, the billing situation) it just blows up. It's easy for me to say that now, a few days later, because hindsight is 20/20. But at the time it felt like the sky was falling and I was drowning. I am lucky the doctor didn't dismiss me, took the time to see me, and gave me the time I needed to get through it. I am extremely grateful.
Toward evening I had mellowed out significantly and my blood pressure was back to normal and so was my pulse. The next day I tried doing my own research about what we owe. While waiting for the supervisor from the clinic to call me back, I called my insurance. It sounds like yes we did indeed max out our lifetime fertility benefits. Our Aug claims only had about $900 covered and the rest of the cycle was not. For some reason the clinic didn't submit the claims until December which is why we only received notification at that point. I don't know why we weren't told about the pending/denied claims earlier. I don't know why we weren't told about disbursement of the pre-payment for pending claims. The insurance person went over all the claims that we may owe that are still pending.
One piece of surprising news in all this: while on the phone with insurance, I was told that the Aug - Dec claims were denied but one of the claims submitted in January was covered. Huh? Thanks to some policy change that we didn't know about or realize happened, turns out the plan we signed up for was slightly different than last year and that change resulted in an entirely new plan which means that as of 1/1/19 our lifetime maximum for fertility benefits has been renewed. What!!!!! I didn't even know that was an option!
So we're still on the line for thousands of dollars until we hear otherwise but hopefully having a renewed lifetime max will mean that we don't have to put anything on hold. I'm still very upset with the clinic for screwing up our billing, but I'm holding out for the supervisor and give her a chance to fix it before going nuts on them. And I've also learned not to let things fester. If something is bothering me, I need to take care of it. I thought I was managing fine -- I wasn't crying, I wasn't actively depressed -- but clearly I was in denial that something was bothering me. I will need to be more aware in the future to prevent another meltdown.
Monday, February 11, 2019
Hats
I'm feeling more anxious than usual today so I decided to deflect unpacking it and look at hats instead. I didn't watch the Grammy's last night but I saw some snippets on social media and woah. Apparently hats are back in. I don't need anything nearly as glamorous as what J Lo was wearing, but I really liked that black hat with the satin sash on Alicia Keys.
I love hats but hats don't love me. They're all made one size and it's just a bit too small for my head, giving me a headache if I wear them more than a few min at a time. The plain straw fedora I wear at the pool was purchased at a Big & Tall men's store a few years ago when I saw it passing by the window a few years ago.
All the hats online (Amazon) are one size. Other stores online might have better sizing but no free return shipping. I can't get stuck with a bunch of hats that don't fit. I've tried local stores in the past but who goes to stores anymore. I would go to a store if there were legit recommendations. So where do people buy hats?
I love hats but hats don't love me. They're all made one size and it's just a bit too small for my head, giving me a headache if I wear them more than a few min at a time. The plain straw fedora I wear at the pool was purchased at a Big & Tall men's store a few years ago when I saw it passing by the window a few years ago.
All the hats online (Amazon) are one size. Other stores online might have better sizing but no free return shipping. I can't get stuck with a bunch of hats that don't fit. I've tried local stores in the past but who goes to stores anymore. I would go to a store if there were legit recommendations. So where do people buy hats?
Wednesday, February 6, 2019
Schrodinger’s Pregnancy
I was responding to a post on my fb support group from someone who just had a transfer and was kind of going nuts with her emotions asking if that was normal. The immediate term I thought of was Schrodinger's cat and how the 2ww is basically Schrodinger's pregnancy: you're pregnant and not pregnant at the same time. I was so tickled with this thought that I googled it and found this blog post from 2013 on the concept.
What makes this experience unique, compared to situations of waiting in unknown like waiting for results of a job application, is that the box of indeteminancy is located within your own body. That box that contains one truth and the experience of living with two, that is placed in the intimate space of your self.... Every twinge, ache, or fluid becomes a potential messenger–sending us word of what has happened that we cannot know.It's so well said and makes so much sense. There is literally nothing to do but wait. Wait and try to manage expectations while preparing for possible disappointment.
Monday, February 4, 2019
The Curve
Over the years of fertility treatment I noticed something about myself. There's a definite bell curve to
my emotions and how I relate to others depending on where we are in our own cycles.
For me, the peak of the curve is transfer day. Leading up to it I feel happy and relaxed, not jealous at all of anyone. Family occasions are easier to get through, I'm more patient and tolerant of comments. In my mind, my happiness is just around the corner with all the hopes and dreams riding on the upcoming transfer. When transfer happens, the peak plateaus while we anxiously wait for results. If the results are good, the peak rises a bit; but as always has been the case in the past, there was always a significant dip when the transfer didn't work or when the pregnancy ended in miscarriage. Each time we lost a pregnancy, the dip went a little lower and made it harder to climb back up. Almost as though the baggage of previous losses weighed us down and helped gravity sink us even deeper.
This thought only popped into my mind yesterday as I was folding laundry. It was so strange to realize something so fundamentally simple and obvious. It completely explains why it has made riding the upswing of the curve so difficult. As soon as we got the all clear weeks ago I should have been thrilled but I just couldn't enjoy it because I know what it's like to be in the depression of the dip and I'm terrified of being there again.
None of this was news. It was just very interesting to me to realize this about myself. Maybe now that I realize it I can do something with it.
For me, the peak of the curve is transfer day. Leading up to it I feel happy and relaxed, not jealous at all of anyone. Family occasions are easier to get through, I'm more patient and tolerant of comments. In my mind, my happiness is just around the corner with all the hopes and dreams riding on the upcoming transfer. When transfer happens, the peak plateaus while we anxiously wait for results. If the results are good, the peak rises a bit; but as always has been the case in the past, there was always a significant dip when the transfer didn't work or when the pregnancy ended in miscarriage. Each time we lost a pregnancy, the dip went a little lower and made it harder to climb back up. Almost as though the baggage of previous losses weighed us down and helped gravity sink us even deeper.
This thought only popped into my mind yesterday as I was folding laundry. It was so strange to realize something so fundamentally simple and obvious. It completely explains why it has made riding the upswing of the curve so difficult. As soon as we got the all clear weeks ago I should have been thrilled but I just couldn't enjoy it because I know what it's like to be in the depression of the dip and I'm terrified of being there again.
None of this was news. It was just very interesting to me to realize this about myself. Maybe now that I realize it I can do something with it.
Friday, February 1, 2019
Yay
The last week and a half were stressful. Just a lot of stuff going on. Having a lot of stressful things behind me makes me happy.
I really love The Good Place. Last night we caught up with S3 finale and we're still texting each other quotes from the show and giggling. It's such a good show and the character Janet brings me so much joy. I loved Parks and Rec and I hope this show continues on for a long time. Well done, Mike Schur (creator of both).
It's been a month since I focused on better eating and I'm down 13.6 lbs. It was a recent gain after I was on antibiotics multiple times in the fall so I'm glad it's gone. It was alarming at how quickly it can get packed on. It wasn't a steady decrease: it was down some then up some then up and down a few more times until this morning I felt I needed the accountability and finally stepped on the scale. I know I shouldn't equate happiness with the scale but that's easier said than done. Also, in my usual worrier-self I let a moment of doubt creep in thinking, "Oh no, unexpected weight loss can be a bad sign of something seriously wrong" but then knocked it down with reminding myself that I've been purposely eating mainly vegetables and protein, and a lot less baked goods. Plus I had the stomach bug last weekend. In any case, the scale seems to fluctuate so much that tomorrow might be a completely different story. Today I am pleased.
I'm also starting to accept the eventuality of the transfer. At first I was caught off guard because after months of delaying we finally got the all-clear. I wasn't expecting it and wasn't ready. I'm still too superstitious to calculate gestation weeks or due date post-transfer, but right now I feel guilt-free estimating and calculating when trimesters would be based on a hypothetical transfer date. Thinking that it might work and going through the positive what-ifs brings me happiness. I know it's a dangerous game but impossible not to think ahead like that if you're trying to convince yourself that it will happen. Why else would you go through it again?
I know the risks. I know what could happen. I would be lying if I said I wasn't scared.
But I know we can't succeed if we don't try. So we have to try. We have to do our part to help it succeed. Our part is having faith and going through the procedure again while hoping for a different outcome than the last 6 times.
Also, it's Shabbat and superbowl weekend! I have no skin in the game - I have no idea who is playing or how the game is even played but I know I like superbowl food and Maroon 5. Shabbat shalom!
I really love The Good Place. Last night we caught up with S3 finale and we're still texting each other quotes from the show and giggling. It's such a good show and the character Janet brings me so much joy. I loved Parks and Rec and I hope this show continues on for a long time. Well done, Mike Schur (creator of both).
It's been a month since I focused on better eating and I'm down 13.6 lbs. It was a recent gain after I was on antibiotics multiple times in the fall so I'm glad it's gone. It was alarming at how quickly it can get packed on. It wasn't a steady decrease: it was down some then up some then up and down a few more times until this morning I felt I needed the accountability and finally stepped on the scale. I know I shouldn't equate happiness with the scale but that's easier said than done. Also, in my usual worrier-self I let a moment of doubt creep in thinking, "Oh no, unexpected weight loss can be a bad sign of something seriously wrong" but then knocked it down with reminding myself that I've been purposely eating mainly vegetables and protein, and a lot less baked goods. Plus I had the stomach bug last weekend. In any case, the scale seems to fluctuate so much that tomorrow might be a completely different story. Today I am pleased.
I'm also starting to accept the eventuality of the transfer. At first I was caught off guard because after months of delaying we finally got the all-clear. I wasn't expecting it and wasn't ready. I'm still too superstitious to calculate gestation weeks or due date post-transfer, but right now I feel guilt-free estimating and calculating when trimesters would be based on a hypothetical transfer date. Thinking that it might work and going through the positive what-ifs brings me happiness. I know it's a dangerous game but impossible not to think ahead like that if you're trying to convince yourself that it will happen. Why else would you go through it again?
I know the risks. I know what could happen. I would be lying if I said I wasn't scared.
But I know we can't succeed if we don't try. So we have to try. We have to do our part to help it succeed. Our part is having faith and going through the procedure again while hoping for a different outcome than the last 6 times.
Also, it's Shabbat and superbowl weekend! I have no skin in the game - I have no idea who is playing or how the game is even played but I know I like superbowl food and Maroon 5. Shabbat shalom!
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