So today I get a claim form in from my lovely insurance company. The font is suppose to express my dripping sarcasm. I'm obviously use to dealing with them. They'd previously covered the ultrasound for my fetal echo & such, but now they are telling me they are NOT paying for anyone to review them & decide if our baby was OK or not.
Upon calling, they tell me in no way shape or form on screening test covered unless I was having a medical problem. But me having a medical problem doesn't really relate back to our baby needing a fetal echo, & other screenings, which she agrees with so she is basically telling me there is no way that it can be billed to have them cover it, so I ask if experiencing a full term stillbirth less than a year ago would be a medical reason to cover the screenings for this baby. The response?
"You can appeal it, but no, we really don't care about that."
OK. Fine. Thanks for being honest, I had to hang up to go cry then.
I wasn't going to appeal because honestly I'm just so beyond done with all of this. Just done. But I decided I might as well. So I wrote this little lovely letter. I look forward to the rejection to see if they address my question.
May 7, 2010
To whom it may concern:
I am writing to appeal claim number 264544 for the date of service of 3/11/2010 for the total amount of $742.
These were “screening test” for our unborn child. The actual ultrasound portion was fully covered, but the doctor looking at our unborn son and ensuring his health was not. So I guess the ultrasound itself is covered, but we are responsible for the cost of having it read? I’m not exactly sure I understand the point of covered of the actual scan, which was more expensive, if no medical professional reading it was covered.
The code used to bill was a family history of heart conditions. On top of that issue, I also experienced a full term stillbirth less than a year ago that is not full explained to this date, minus a possible kidney issue which can sometimes be related to heart issues as well, which is why my doctors & specialist this pregnancy wanted to have these test done. Simply put, these test were ordered to ensure the health of the baby I’m currently pregnant with. Not to mention my and my husbands own well being, to help diminish our fears and worries of this child dying as well. I’m already being treated for depression and other issues related to my last stillbirth, including being on medication, so I’d obviously like to prevent any in the future if possible.
If these screening test are not covered, I’d like to know how many dead babies WV PEIA would like us to have? Is there a certain number that we must experience before testing will be covered for future children to ensure that we do not experience another dead child, and I myself have to go through labor delivery, & the emotional pain I’ll have to experience each time? I'm curious about how many maternity and delivery charges PEIA is willing to pay out before they assist us in preventing a dead child instead of just paying maternity coverage out over and over again that has the same negative end result.
I’m asking for your company to provide my unborn child with the medical care he deserves so he can have a chance to experience life. And so my family can avoid having another life taken from them.
Blunt? Maybe. Unprofessional? No more than them & I really don't care anymore.