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Jenn1621
<3
Member since 5/05 1728 total posts
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Appealing insurance company decision? UPDATE!
Does anyone know or been through an appeal before? My insurance company will not approve a fresh cycle bc I have frozen. I've done 2 frozen transfers both bfn. Just curious how long it takes to appeal, I only have coverage until Jan after that I am all oop. I was hoping to get a fresh in considering I only have 10k lifetime as well.
I received a call from Michelle today, insurance approved me to start a fresh cycle, perfect timing as tomorrow is my day 3! My husbands job called to check on it as well since the paperwork was submitted yesterday and the rep said all ppwk was rec'd and very detailed so he had a good feeling. This is my last shot with insurance so I'm hopeful this is it!
Message edited 10/22/2014 2:51:41 PM.
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Posted 10/20/14 4:14 PM  |
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hmm
Sweet
Member since 1/14 7993 total posts
Name:
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Re: Appealing insurance company decision?
Posted by Jenn1621
Does anyone know or been through an appeal before? My insurance company will not approve a fresh cycle bc I have frozen. I've done 2 frozen transfers both bfn. Just curious how long it takes to appeal, I only have coverage until Jan after that I am all oop. I was hoping to get a fresh in considering I only have 10k lifetime as well.
I have the same max and mine ends in one week. I hope to start a cycle before it ends but they might not approve either.
Appeals in general can take time but you can move things along in my experience with persistence. See about insisting on an emergency decision one that take 48 hours for a turn around. I don't know which office you go to, but see if they will help. See if you RE will make a case stating your chance would be better if you try a fresh cycle.
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| Posted 10/20/14 8:25 PM |
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Jenn1621
<3
Member since 5/05 1728 total posts
Name:
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Appealing insurance company decision?
Thanks! I actually spoke to my nurse today at liivf and she suggested calling finance and see what they say if they think it would be approved. Of course, I started my perood so time is not on my side as I would need to start birth control on day 3, 4 or 5. I guess If it is going to take forever I may as well do the last frozen but my frosties are not great as far as what is left. So frustrating that they dictate what we can or can't do!
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| Posted 10/20/14 9:30 PM |
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hmm
Sweet
Member since 1/14 7993 total posts
Name:
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Re: Appealing insurance company decision?
me too
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| Posted 10/20/14 9:53 PM |
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Mrs&MrsK
i need sleep ;-)
Member since 2/14 2008 total posts
Name:
L
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Appealing insurance company decision?
I did an appeal but it was a pretty simple one-- they promised a reply in 60 days but ONLY if the Dr provides the ppwk to them on time. if not, they will extend (or drop it) so you have to stay on top of it. LIIVF was slow in getting the info to them FYI.
This was an appeal after receiving my EOB.
you can't rely on the dr or the insurance company to follow through-- you have to keep on it yourself!
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| Posted 10/21/14 9:12 AM |
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MrsWoods
LIF Adult
Member since 4/12 1461 total posts
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Appealing insurance company decision?
I did an appeal but it was for IUI coverage. Basically i gathered all paperwork and test results from all my doctors including my letters of recommendation. And sent it over with a cover letter as to why i feel it should be covered with proof of everything i said. It took 2 months for a reply but it was successful.
Message edited 10/21/2014 11:26:53 AM.
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| Posted 10/21/14 11:26 AM |
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Jenn1621
<3
Member since 5/05 1728 total posts
Name:
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Appealing insurance company decision?
Thanks for all the advice ladies. I got in touch with Michele at liivf and she said she was sending all paperwork today and that they would put a rush so it would take 2 days to find out. She said she would keep on top, because I did two fets and both were negative she said she would see if they would now approve the fresh considering the 2 left are the poorer quality ones. I've already used my 8cells and 10
Cells and that didn't work. Given I started day 1 today and I only have coverage until 12/31 I'm on a bit of a time crunch. Hopefully we know in the 2 days and if it's a no then I guess I will do the last frozen and use up whatever benefits I have left out of the 10k although ideally I would have liked to put that toward a fresh. Ugh!
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| Posted 10/21/14 12:49 PM |
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Jenn1621
<3
Member since 5/05 1728 total posts
Name:
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Appealing insurance company decision? UPDATE!
Updated on top!
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| Posted 10/22/14 2:52 PM |
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