Posts Tagged ‘miscarriage’
Insurance
I would appreciate any help anyone can give me on this.
I had a miscarriage in July late on a Friday night. I called my doctor’s office who then told me to go to the Emergency Room which I did. I have BCBS health insurance and should only have a $50 copay for the emergency room.
I received my first bill in August or Sept. and nothing was being covered. When I called BCBS, I was told they need the date of onset and that it wasn’t being coded as emergency. I called the hospital and told them that. I thought this was taken care of.
Fast forward to now. This is a $1406 bill. I just hung up with BCBS, and they have now decided not to cover it because a missed abortion (which I guess is a miscarriage) is not an emergency service. It is an outpatient service even though I was treated through the emergency room and went there per my doctors request. They also told me it was pointless to try and get them to review the denial.
Here’s where you guys come in. I am sitting here crying and I don’t know what to do next. Anybody know how to fight this? BCBS won’t give me the CPT code that they need to cover this. I just don’t understand how they can deny the claim when I was told to go to the energency room by my doctor and then it is not an emergency. Any help would be greatly appreciated. Thanks!
About Me
Lisa Martin is a native of Wisconsin but now resides in the Chicago area with her husband and two children ages 7 and 4. She is a work-at-home mom who uses her skills and talents for freelance jobs. At any given time, she’s usually tied-up with three or four projects in addition to her full-time blogging.
Lisa started blogging in April of 2006, as a means of keeping in touch with long-distance family and friends. After experiencing some personal issues in July of the same year, she learned she could help others with her experiences…through blogging. Lisa now discusses all of life’s issues while managing her four blog: My Thoughts, Ideas, and Ramblings; Lisa Reviews; Lisa Cooking; and Lisa’s Travels.
Lisa has participated in several exclusive media projects, including the Sony Mommy Bloggers Event in April of 2008, the Pampers Mommy Bloggers Event, the Epson Event in Chicago, the Stouffers Event in April 2009, a yacht ride with Lands End in July 2009, and 1-800-Baskets in October 2009. In addition to these personal appearances, Lisa’s blog has also been quoted in The New York Times and she has been interviewed by the Southtown Star, The Chicago Sun Times, and inside. She also spoke on the doterati panel Blog Marketing Demystified in October 2009. In 2010, she was invited to a blogger exclusive Mrs. Prindable’s tour and was also invited to The International Housewares Show. In 2011, she attended a special Hallmark event here in Chicago and a PopCap games event.
Positive Triple Screen Test
I discussed this somewhat on my other blog, but I figured I’d talk about it here too. Whenever I figure out how to combine both blogs, this may end up being a double post, but what ya gonna do. Let me give you a bit of history for those of you who do not know me.
I use to be on Depo Provera. When I went off of it to try and get pregnant, I was under the assumption that it would take up to 18 months to get my cycle back. I had a kidney stone and when they did a CT scan (at least, that is what I think it was) I went a new OBGYN and he told me I was wrong about the Depo and ran a bunch of tests. He first told me that I had premature ovarian failure. Then when my test results did not come back to confirm that, I had polycyctic ovarian sydrome. He then started me on hormone replacement therapy. It made me sicker than I have ever been before. Then he wouldn’t return my call when I complained about it. I decided to go to another OBGYN and get a second opinion. Guess what? It takes up to 18 months for Depo to get out of your system. My cycle returned about 18 months after going off of it. I think it still took us another 6 months to get pregnant with Madison.
Getting pregnant with Madison was the easy (and fun) part. What was next to come wasn’t. I ended up in preterm labor with her 6 times (4 times it was stopped with medicine). One of my many visits was Christmas Eve. I ended up with 6 ultrasounds on the kid. On the 5th ultrasound, her waist was measuring short, so we had to get another one. They thought she had IUGR. Of course, after 5 ultrasounds, she was stubborn and would not show us if she was a boy or girl. On #6, she was cooperative. We found out she was a girl and that her waist was measuring fine. The funny part of this story is that she is most long waisted kid you will ever see now. At 2 years old, I had her in 4T shirts because otherwise they were too short.
Fast-forward to now. Madison is now three. In July, I suffered a miscarriage at 5 weeks. It was devastating. We decided to try again and I am now 4 months pregnant with a due date of June 25. On Thursday night, we got a phone call from my OBGYN and are slowly seeing our world crashing in on us again. My triple screen came back high. What does that mean?
That means that I have a higher risk for having a baby with a nueral tube defect. We went on the internet and did a search on that term. What this usually means is spinal bifada or Anencephaly (this is the really bad one. This is fatal).
I also found out that there is a high false positive rate for this screening test. However, I keep going to the place where what about the people who aren’t false positives. What happens if we are one of those?
Here’s our plan of action. I already have a Level II ultrasound scheduled for Feb. 2nd. Before the ultrasound, we have to meet with a genetic counselor who will tell us our odds of how bad this is. Then we have the ultrasound. We should be able to tell from the ultrasound how bad it really is (or how good). However, if the baby does not present correctly, we may still not have an answer. We then need to decide if we want an amnoicentisis (sp?). They will do one immediately if we decide to do it then. If they fast track it, then we would have an answer by Tuesday. Otherwise, there is a 7 – 10 day wait for the results.
Needless to say, I am a wreck. Bill keeps telling me to think positive and I am finding it hard to do. I think the miscarriage has jaded me. I am trying not to go to all the dark bad places in my head, but it is hard. And the wait till Friday might kill me. So if I seem a bit bitchy or mad or sad, this is why.






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