Hey, y'all, check out the email I just got back from the insurance company:
Hi Jessica,
I'm sorry this has taken so long to get information to you. But I just heard from our case management area. They have reviewed a copy of the contract today. The contract states a member must have a documented history of infertility of two years duration. The clinical information provided indicates you had a miscarriage in 2011, and therefore does not meet the criteria outlined in the contract. The request will be denied based on the terms of the contract. Your provider will be notified by phone today and letters will be sent to the provider and you. You may appeal by contacting Member Services.
Again, I'm really sorry for the result of the outcome of your request but you do have the option to appeal.
Thank you for your patience.
It's nice to learn that I had a miscarriage in 2011. Hell, it's nice to learn that I was pregnant in 2011. Wouldn't you think that I'd learn that from someone other than my insurance company?!? I emailed back asking where it was in the clinical information, and I just left my nurse a message as well.
*Headdesk* so many times that I would have splinters in my forehead if my desks were real wood
At least this one is fairly easily fixed, an error in the system somewhere rather than a valid reason for denial. But I'm so sorry you have to deal with yet more red tape, Sweetheart.
ReplyDeleteFight them! That's ludicrous what they're doing, trying to wriggle out of doing the right thing. Can't say I trust insurance companies much! Best wishes and I hope you can get it sorted without too much angst.
ReplyDeleteVisiting from ICLW!! So sorry you are having to go through this!This whole process is hard enough without having to deal with insurance!
ReplyDeleteInsurance companies are so damn annoying. I hope that things get fixed asap!
ReplyDelete<3 Kayla
(Here from ICLW)
Thanks, guys. Kaitake, I'm continuing to fight, even as it gets worse and worse. :-p
ReplyDelete