Re: insurance question (pg mentioned, m/c mentioned)

[Guest guest]

In a message dated 5/12/2004 12:02:07 AM Central Standard Time,

jazzerita@... writes:

> I'm

> hoping that this will be enough to have it done just as gynecological

> care instead of infertility care, even though I will want a septum

> resected if I have one so that I can avoid more 2nd trimester m/c's.

> Have any of you had an experience with getting procedures fully paid

> for by insurance as part of non-infertility care? Any feedback would

> be much appreciated (even opinions!).

>

Hi Jasmine

Insurance companies try to get out of paying if you're labeled as

" infertile " . A Mullerian Anomaly, however, is a birth defect, a congenital

anomaly, and

as such should be covered by the insurance. It's just like having a cleft

palate fixed. I had to fight hard to get rid of the infertility label, but once

I

did, the insurance paid. They will probably try to tell you otherwise, but

don't let them intimidate you!!!!

Good luck and don't give up!

Heike

SU resected after a tough battle with Cigna (lol)

2 kids

[Guest guest]

Hi Jasmine...

I would call Kaiser and double check with them about their coding. I

had all the same - HSG, Lap/Hyst etc. done to also diagnose my SU but

it was coded as a birth defect not as infertility. Just because you

see an RE should not automatically qualify you as having infertility

issues. That was one of my first questions to my RE was how was this

categorized as. I have UHC but I paid nothing but $10 copays to see

the dr and everything else was paid for by my insurance- tests, blood

tests, surgery.

I would definitely recommend going to a specialist vs a regular ob

because they may know about the anomalies but don't really keep up

with the detailed things we with anomalies need.

HTH-

carol

[Guest guest]

Hi Jasmine,

Gosh, I have heard of few gyne stories on this board where the gyne

was experienced enough to do a lap/hys and resection. They usually

only get to " practice " those procedures a few times during

residency. I'm don't think that I can recommend that you have your

gyne do the procedure.

However, the way that most women get their insurance to pay for this

is to make SURE that your RE codes it as a birth defect and NOT

infertility treatment. Birth defects should be covered by your

insurance and an MA is most certainly a birth defect.

I hope that others that have had to deal with this will chime in.

Call the REs office that you cancelled with and ask their billing

department if they are familiar with coding for birth defects for the

dx of an MA instead of coding for IF.

Good luck,

Sara

SU resected x2

[Guest guest]

Have your dr's list this as a birth defect as that is what it is. That is

what my dr's listed it as and it did not go under infertility. - Liz

Liz

>

>Reply-To: MullerianAnomalies

>To: MullerianAnomalies

>Subject: insurance question (pg mentioned, m/c

>mentioned)

>Date: Wed, 12 May 2004 05:00:42 -0000

>

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[Guest guest]

My Dr. also finally listed my re-section as a birth defect and it was covered

with no questions asked. good luck DawnFrom: Liz [mailto:

elizabethgreer2@...]To: MullerianAnomalies@...: Fri, 14 May

2004 16:30:37 +0000Subject: RE: insurance question (pg

mentioned, m/c mentioned)Have your dr's list this as a birth defect as that is

what it is. That is what my dr's listed it as and it did not go under

infertility. - LizLiz & gt;From: " jazzerita " & gt;Reply-To:

MullerianAnomalies & gt;To:

MullerianAnomalies & gt;Subject: insurance

question (pg mentioned, m/c & gt;mentioned) & gt;Date: Wed, 12 May 2004 05:00:42

-0000 & gt;_________________________________________________________________Best

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