FINALLY, after 29 days, I have the letter of medical necessity in my hot little hands. I hope it's good enough. I wrote a cover letter for it and copied the supporting documentation, and I'm heading to the post office on my way in to work to overnight it to CareFirst (or whatever will get it there early Monday) since I don't have their fax number and I haven't had a chance to call and get it. Then they have 30 calendar days to decide on the appeal.
In the meantime, my nurse at the fertility clinic is putting in the referral for the Maryland-based PGD lab. So they'll get the referral, look at it, and call me to discuss what they need from us to create the probe, and then that takes 3 weeks to create once they get what they need.