Deny us Kaiser…Please

Dejected.

Devastated.

Angry.

Sad.

Hopeful.

 

We walked into the doctor’s office expecting good news. We sat down in the lobby cracking jokes to each other, and we fully expected that this would be the day we chose our child.

40 minutes later we walked out in shock. We had to start the entire process over again. Not one embryo came back healthy. There were 4 boys and 1 girl. When we were shown the list all I could think was “That was supposed to be her”. The car ride home was silent. You could cut the anger with a knife. It soon gave way to sadness and then finally…what’s next? She has to put her body through the entire procedure all over again.

What else is next? It’s a little technical, a tad bit boring, and incredibly infuriating. I can’t begin to imagine what other folks have to deal with in a broken health care system. If the insurance company doesn’t act, we may well lose out on our last opportunity to have a child. But then again, you can’t really call our current Health Care System a “System”.

While we both undergo more tests to pinpoint the exact problem the other pressing issue is dealing with Kaiser, a company we don’t have IVF coverage under. You see, we are both covered for IVF under my plan (United). But she also has a previous plan from her work that is considered her “primary” plan…enter Kaiser Permanente.

Because Kaiser is her primary carrier, before we receive any coverage from my insurance company, everything has to be sent to Kaiser first so they can reject the claim (Kaiser does not cover or deal with IVF), then processed, and then the rejection notice needs to be sent back to my insurance company in order for our claims and orders to be processed by United Health Care.

90 days…is how long it takes Kaiser to reject a claim after receiving it. 90 days to say no to a procedure they don’t cover. No to a process they have no part in.

All we need is a “no” from Kaiser…that’s it. Not receiving that “no” from Kaiser puts our coverage under United at risk because if a claim takes too long to be filed, the carrier may reject the claim even though we are covered.

So after calling Kaiser multiple times they told us it’s not their problem. Kaiser’s slogan is “Thrive”. Kaiser, we are trying to; with all of our strength. You’re putting everything we’re working so hard for in jeopardy.

I doubt you’ll listen because you haven’t so far. Let us thrive so we can try to have our family.  

We just want you to say no.

Also, I’m doing a back-yard project and require some tape, red in color so we can see it against the fence. I hear you really thrive at making the stuff.

 

 

 

 

 

 

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