Sunday, November 1, 2009

Some Possibly Exciting Developments!

I'm sorry I haven't posted lately. With us not actively fundraising at this point, and having not made any concrete decisions, there just hasn't been much for me to say. HOWEVER, I got a letter last week from our RE (reproductive endocrinologist-or more simply put-our fertility specialist). It basically said that they are merging with another fertility clinic. This new clinic is very well known in our geographic area for their shared risk IVF program. That program isn't really on our radar, but I will tell you about it just for kicks anyway. Basically, you pay $20,000 and you have 6 IVF cycles (usually 3 fresh cycles where you go through all of the injections, egg retrieval, and embryo transfers, and 3 frozen embryo transfers where I'm sure there are some drugs involved in prepping you for the transfers, but having never made it to have embryos worth transferring, I'm not quite sure what that would involve.)

That said, the letter we received stated that our RE and his nurse will be seeing patients for routine things like consults, ultrasounds, and lab work at our hospital (my insurance had stated that this was the only location we could have our IVF procedures done), but that actual procedures would be done at another hospital affiliated with this other fertility clinic as of December 15th, 2009. This got me wondering if this would mean an increase in fees or perhaps a decrease for those patients paying out of pocket. I was also wondering whether our insurance company was going to put any stipulations on our infertility benefits now that the procedures would not be occuring at our hospital. So I called the billing lady at our hospital. She explained that as far as the fees, they may actually be decreased since the other fertility clinic has a dedicated area for the IVF procedures whereas we were facing a $3,000 bill at our hospital because the area that they used is part of the L&D area-their recovery area, and their operating room. This is great news! She didn't know what we were looking at exactly as far as fees, and gave me the number of a billing person at the new center to call. She also advised me to call our HR rep to find out if the insurance was going to have any stipulations we needed to be aware of should we choose to go this route.

I called her contact at the new fertility center, and he told me that he was actually in charge of billing for freezing and storage of embryos, so he couldn't tell me exactly what we were facing with fees, but that when we met with our RE (at any of 12 locations-nevermind the logistics of him seeing patients at so many places), he would then refer us to the billing people. One person would call and figure out our benefits regarding our insurance and then we'd be assigned a financial coordinator who we would work with throughout our cycle. He said a good estimate of what to save would be about $5,000 since our insurance is going to pay a little over $5,000 as well, and with the insurance paying part of it, there would be an allowed amount that they would pay, and then adjustments and credits which would lower the amount we would be responsible for out of our pockets. $5,000 is a bit more manageable than $10,000.

Then I called my HR rep to confirm that the insurance was on board with all of this. She asked me how I knew about the merger, and I told her about the letter. She wasn't aware that anything was definite. I told her there was a date as to when these changes were taking place. She requested a copy of the letter...whoops! Hope I didn't get my RE in trouble, but you would think the left hand would talk to the right. The HR rep said that nothing had been released formally to the employees yet, and perhaps it hasn't been released yet to all of the employees, but I can tell you that my coworkers who see the same RE got the same letter I did.

Obviously, we're not moving forward with any cycles until we've spoken with the correct billing people in addition to all of my physicians. But with our tax refund next year, we may be able to do a cycle earlier in the year than we thought if everything lines up right. All of the money is due up front prior to the start of our cycle, and if there is any money left over at the end from what we paid, we would be issued a refund. I just hope it's only $5,000 or so that we have to come up with because then it might not be another year before we can do something! And yes, I am saying that if our docs are in agreement, our RE has the right plan (which is basically to go back to the protocol we used for our IVF cycle in 2006), and the cost is right, we'll be doing another cycle. If it's unsuccessful, I'm sure we'll be upset, but we will also consider our family complete, and be blessed for what we've been given. It will be our last attempt at expanding our family (as would adoption if we went that route) which makes me feel panicked just thinking about it. I will continue to look at the good things that can happen and just push those negative thoughts to the back of my mind.

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