Wednesday, August 7, 2013

Oh, FFS!*

Last night I received a letter stating that I have to pay my doctor's office all of the claims that were previously sent to my insurance totaling in over $1,800.

Cue head exploding
Let's back up, shall we?

Back in May, when we decided to go ahead and schedule my HSG, I was freaking out, trying to figure out how we were going to pull $4,000 out of thin air. I knew that the insurance I have through Keegan's work wouldn't cover any of the cost, so I decided to call up the insurance my dad has, (for some reason,) kept me on. Thankfully, they said they would cover the entire procedure, minus the $250 deductible.

Fast forward to the day of my HSG and I'm sitting in an office in the hospital discussing insurance and payment. I told the lady that I wanted to put my dad's insurance as primary because they would cover the procedure and Keegan's as secondary, just in case, thinking this had nothing to do with how my regular doctor's office billed my claims. I swiped my debit card for the $250 deductible and went on my way to get x-rays taken of my lady bits.

My HSG was almost two months ago and we haven't heard anything from either insurance company, until last night. We got a letter from my doctor's office saying that "BCBS (Blue Cross Blue Shield) recently recouped all previously paid claims stating "other primary insurance..."  as well as stating that we owe $1,826.

Basically, because I used my dad's insurance to cover the HSG, BCBS thinks I have other primary insurance so they shouldn't have to cover any of my claims from the last year. I honestly didn't realize that making my dad's insurance primary for the HSG would affect my claims, especially all of the ones from the last year!

So, now we're stuck. Keegan is going to call BCBS to explain what happened, but from what I understand, we have a few options:
  • We can keep my dad's insurance as primary and submit all of my claims from the last year to see if they'll cover any of them. 
  • We can keep my dad's insurance as primary and pay the $1,826
  • We can make BCBS primary for the HSG and submit the claim to them to see if they'll cover anything. Since I know they won't we'll have to pay the $4,000. 
  • Figure out how long I'll have to keep my dad's insurance before switching back to BCBS without having to pay back any of the claims. I'm thinking the beginning of 2014? 
Either way I see it, we're boned. Am I the only one who didn't realize this would happen? I honestly thought that since the hospital and my doctor's office are two separate offices, making my dad's insurance primary wouldn't affect the insurance at my OB/GYN. Looking back, I guess since my OB/GYN was the one who ordered the procedure, they would be the one to file the claim, right?

More than anything, I'm embarrassed this happened. I guess I was so nervous out about the procedure as well as excited that we found a way to cover it, I didn't think when I gave the hospital my dad's insurance. I'm also mad that we have to go through this. It all comes back to the "most women can get pregnant with a bottle of wine and a night with their husbands while I'm paying thousands of dollars just for the chance" mentality that I'm sure we've all had.

Does anyone have any advice? I'm sure I'm not the first one to mess things up like this, right?

*I figured "Oh for fuck's sake!" wasn't an audience pleasing title


  1. I'm not exactly sure who to ask this of, but if you put Keegan's insurance as primary, have the hsg processed through that, they don't cover it, and then have it processed through your dad's insurance, would they cover it the same as if your dad's WAS primary?

    1. Yeah, having your dad's insurance as secondary might work

  2. I used to work in a doctor's office and when we billed primary insurance for a procedure that wasn't covered, we would submit the denial and the claim to secondary, who would pick up what the primary didn't. You should just tell them it was a mistake and the primary should always have been Keegan's and the secondary your dad's. Unless there's some complicated other thing going on, it should go through fine. Good luck!!

  3. Yes, that's my understanding as well. You have one insurance as your primary and the other as secondary, and if something is denied by the first insurance, then it goes to the second one.

  4. I so do not have any advice, but that "most women..." statement gets me every...single...time. I cannot let myself sit and think about it or I will go absolutely crazy. So sorry about this added complexity to an already shitty situation.

  5. Oh, I so hope this works out for you. I had a breakdown yesterday on the unfairness of the financial woes that take over with infertility. I come back to "most people" don't have to mess with this crap and it sucks. I'm just really sorry that it sucks.

  6. Hi from ICLW. Insurance stress on top of stress and nerves about procedures is the worst. I hope you got it all figured out.