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TyReseGreen
Lil Prince is here
Member since 8/11 6338 total posts
Name:
Theresa
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update....UHC is a bunch of
Update:
The rep from UHC called me to make sure I received the letter and went on to explain what I've used which is the 19k plus. It sucks because I'm going for my saline sono tomorrow and already cycling so will have to more than likely pay for this FET OOP. I asked the rep why I was told a different amount and they said its a button they click that gives that figure where as her department reviewed each claim. This sucks
So with my insurance you have to register with Reproductive Resources which I did. The nurse said I had reached the max of my benefits. I then called UHC(this was early Sept) who stated I have used a little over 14k with lifetime max of 20k but can get an additional 10k if I register with reproductive resources and use a Center of Excellence practice (which I'm not but still didn't reach the 20k). The stupid nurse then request an audit. I received a letter yesterday stating I've used 19k. I then called UHC who says I've used 14k as of yesterday's date. I explained I received a letter stating something else. They informed me that during the audit they just add all of the claims that were sent from Infertility Specialists but doesn't necessarily mean that it was coded and billed as infertility treatment so I still only used 14k.
WTH?! I've already started my FET cycle and don't want any surprises going forward.
Message edited 9/29/2014 4:54:33 PM.
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Posted 9/27/14 5:25 AM  |
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TyReseGreen
Lil Prince is here
Member since 8/11 6338 total posts
Name:
Theresa
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update....UHC is a bunch of
Bump
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| Posted 9/29/14 4:54 PM |
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hmm
Sweet
Member since 1/14 7993 total posts
Name:
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Re: update....UHC is a bunch of
Posted by TyReseGreen
Update:
The rep from UHC called me to make sure I received the letter and went on to explain what I've used which is the 19k plus. It sucks because I'm going for my saline sono tomorrow and already cycling so will have to more than likely pay for this FET OOP. I asked the rep why I was told a different amount and they said its a button they click that gives that figure where as her department reviewed each claim. This sucks
So with my insurance you have to register with Reproductive Resources which I did. The nurse said I had reached the max of my benefits. I then called UHC(this was early Sept) who stated I have used a little over 14k with lifetime max of 20k but can get an additional 10k if I register with reproductive resources and use a Center of Excellence practice (which I'm not but still didn't reach the 20k). The stupid nurse then request an audit. I received a letter yesterday stating I've used 19k. I then called UHC who says I've used 14k as of yesterday's date. I explained I received a letter stating something else. They informed me that during the audit they just add all of the claims that were sent from Infertility Specialists but doesn't necessarily mean that it was coded and billed as infertility treatment so I still only used 14k.
WTH?! I've already started my FET cycle and don't want any surprises going forward.
so sorry for the added stress. I know the feeling, I would want to know the cost before I start
Message edited 9/29/2014 5:42:14 PM.
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| Posted 9/29/14 5:41 PM |
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TyReseGreen
Lil Prince is here
Member since 8/11 6338 total posts
Name:
Theresa
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update....UHC is a bunch of
Now UHC just called and they insist that I have 14k left and that's based on the claims and the coding as Fertility Treatment due to Infertility. So it depends on that and that total is 14,668 used.
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| Posted 9/29/14 6:26 PM |
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hmm
Sweet
Member since 1/14 7993 total posts
Name:
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update....UHC is a bunch of
do you get charged a co-pay for blood and sono ? im new to co-pays I thought its only a charge if I see and NP or MD. Im told an office can charge for a office visit causing me to pay a co-pay even if its only blood and sono and the fertility part of insurance says some thing else. confused
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| Posted 9/29/14 7:45 PM |
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TyReseGreen
Lil Prince is here
Member since 8/11 6338 total posts
Name:
Theresa
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update....UHC is a bunch of
I have no copays for anything. I just have a deductible which was met for the year..
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| Posted 9/29/14 11:19 PM |
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IVFmiracle
Complete
Member since 12/12 4088 total posts
Name:
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Re: update....UHC is a bunch of
Is UNC working with a secondary company that provides client services? I had UHC and all questions I had went through Anthem. They took care of things like this for me.
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| Posted 9/30/14 3:45 AM |
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cowgirlkate
Twins times TWO!
Member since 1/11 1197 total posts
Name:
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Re: update....UHC is a bunch of
Just wanted to send hugs! 
Insurance companies are so frustrating.
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| Posted 9/30/14 7:40 AM |
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TyReseGreen
Lil Prince is here
Member since 8/11 6338 total posts
Name:
Theresa
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Re: update....UHC is a bunch of
Posted by cowgirlkate
Just wanted to send hugs!
Insurance companies are so frustrating.
They really are!!! Lack of communication big time. At this point I'm going to just finish this cycle (hopefully it works) and if I get a bill in the end I will just pay it. Don't need anymore added stress
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| Posted 9/30/14 9:26 AM |
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NYCGirl80
I love my kiddies!
Member since 5/11 10413 total posts
Name:
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Re: update....UHC is a bunch of
Just to keep some perspective around this, many people don't have any IVF (or IF) coverage at all and everything is OOP. I WISH I'd have $20k coverage. You're really lucky.
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| Posted 9/30/14 11:46 AM |
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YOLO13
LIF Adolescent
Member since 12/08 669 total posts
Name:
Unlisted
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update....UHC is a bunch of
so sorry you are going through this at this time. i hate my insurance co as well. they tell me one thing and RSONY tells me something different. Either way we are oop but i would like to know what I'm responsible for. good luck and stay positive...
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| Posted 10/1/14 8:03 PM |
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TyReseGreen
Lil Prince is here
Member since 8/11 6338 total posts
Name:
Theresa
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Re: update....UHC is a bunch of
Posted by YOLO13
so sorry you are going through this at this time. i hate my insurance co as well. they tell me one thing and RSONY tells me something different. Either way we are oop but i would like to know what I'm responsible for. good luck and stay positive...
That's my issue. RS of NY is saying whatever they don't cover I pay OOP but not knowing exactly what I'm going to have to pay OOP is what's scary.
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| Posted 10/1/14 10:56 PM |
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TyReseGreen
Lil Prince is here
Member since 8/11 6338 total posts
Name:
Theresa
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Re: update....UHC is a bunch of
Posted by hmm
do you get charged a co-pay for blood and sono ? im new to co-pays I thought its only a charge if I see and NP or MD. Im told an office can charge for a office visit causing me to pay a co-pay even if its only blood and sono and the fertility part of insurance says some thing else. confused
Not a "copay" but I have a deductible I have to meet so its small amounts I have to cover here and there. According to the claims I pulled off UHC site they bill blood and sonos as short visits but not sure if they get coded as fertility treatments.
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| Posted 10/1/14 11:01 PM |
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