We finally have an appointment for my first IVIG infusion. It took a lot of work on the part of my doctor's office to get this going. We have a PPO, and for whatever reason, they have decided to not require authorization on many treatments. The list of what does not need approval is strange and doesn't make much sense, but that's beside the point. Because I did not need authorization, I did not have an authorization or referral code. That just wouldn't do for the infusion center. They wanted hard proof that they would get paid.
Ugh. This was like deja vu of the incident a year ago when I was trying to get breast cancer screening approved. Round and round we go. The insurance company mailed a letter stating that they will pay the charges, but we have to wait for the infusion center to get the letter. My doctor's office sorted that part out, and said it should be a few days. Okay. I can wait. I hate waiting, but I can wait.
For some unknown reason, I got a call today from a lady at the infusion center. She told me the exact opposite of what the doctor's office told me. "You have to pay 90%, your insurance only pays 10%." WHAT? I tried explaining that the doctor's office already sorted it out, and that we were just waiting a letter that was already in the mail. She kept insisting I call to get a letter, and was going round and round. I finally told her that I'd call back in a couple hours. I couldn't take anymore and still remain civil.
Of course, the insurance company reassured us that our maximum would be $1000 out of pocket, and we should be reaching our yearly maximum soon anyways. Now we're trying to work out the scheduling, which is proving to be a pain in the rump. It shouldn't be, but it is. Murphy's law, I suppose. I've heard that once you're in the system, getting monthly treatments is MUCH easier. I sure hope so.
Geez! All this sounds so familiar. Round and round we go, but this isn't fun, like a Merry Go Round is!!
ReplyDeleteI hope things start to smooth out for you ;o)