Thursday, August 2, 2007

Don't they understand that it is personal? (Updated)

I know it isn't really personal, but it feels personal.

But let me start at the beginning. My clinic doesn't have a typical shared risk program. What they do offer is what I call the "buy 2 get 1 free" package and what the clinic calls a "x3" package. If you have a baby with the first cycle, then you just spent several thousand dollars more than you would have if you bought just one cycle. If you do need the second cycle, chances are you will have saved a couple thousand dollars. If you need the third, you will save around $10,000. The goal from the clinics perspective is to have it all even out in the end so it neither costs them or makes them money.

To that end, the price varies depending upon the woman's age and the typical cost of the cycle. Someone under 35 only pays $12,000 for up to 3 cycles (drugs and extras like ICSI, AH not included). For someone 38-40 it is $15,000 and for donor eggs it is $15,500 for 3 cycles.

Here is the issue. After our 3rd failed IVF cycle, our RE offered us a "special x3" where we would buy 1 more cycle with my eggs and up to 2 cycles with donor eggs. I remember Brad and I looking at each other and thinking, "Sounds great!" Well, when I tried to pay for this package (thinking the cost would be somewhere between $15,000 and $15,500) I couldn't get the billing people to acknowledge what I was saying. It was like it was such a foreign idea, they couldn't even hear it. "Fine, just charge me for x3 for my eggs." I figured we could work out the details if we needed to move on to DE.

Flash forward to the DE cycle and they want to credit me for the x3 cycle and charge on a per cycle basis. If we get pregnant this cycle it would end up costing us between $1500 and $2000 more than x3 cost. If we needed a third cycle it would be about $10,000 more.

By this time I have talked to at least 2 people several times each and one finally said they would take it to the financial committee and get back to me. I told them that sounded good and if the answer came back less than what I expected to please have the doctor call me.

Well, they said I could use the x3 for my cost only. For those of you unfamiliar with donor eggs, the vast majority of the cost is for the donor! Although I haven't figured the cost at this point, I am sure their plan would cost me more for 2 or 3 cycles. Of course, I asked for the doctor again - after all it is his clinic and it was his suggestion.

Response so far? I will see if the doctor will call you back but I don't think it will make a difference. He is not part of the committee, but he was part of this discussion.

I am sitting here waiting for the call that may not come. I feel personally shunned. I even feel a bit betrayed. I know it isn't personal, but anything remotely associated with TTC can feel personal.

I just hope the RE calls back today. I just can't believe he wouldn't stand behind what he promised. At least, he'd better have one darn good reason why not.

Update: As the afternoon wore on I decided to call and check the status with the billing lady. It turns out my doctor is out today and she will try to have him call tomorrow. She will call me either way. I spent half of my lunch break crying. Why does every little thing seem so hard sometimes? Ug. Well, trying to let it go for now. I will update as I get it.


SULLY said...

WOW. That awesomely STINKS. WTF are they thinking! You and Belinda are NOT just another set of numbers! You both are people with feelings and emotions!

I hope they call you soon!

Lori Lavender Luz said...

OK. I'm mad and anxious on your behalf. You are now free to have a good day until the phone rings with (hopefully) good news. Then we can both feel better.

Meg said...

Wow thats aweful I hope you get it squared away with the doc. I accidently deleted my blog and had to start a new one. Heres the address

Irish Girl said...

Thinking of you! Hope you get (good) news SOON!

Babe* said...

It amazes me how personable doctors offices can be until the words payment, money or account come into the conversation.

I hope the doctor himself calls you tomorrow to deliver the good (fingers crossed) news.

Leah said...

That sucks. You hate to look like a shithead and ask for something in writing when the Doc offers it, but it's situations like this that make me realize sometimes it's necessary. In our last consult, our RE said that he'd pick up half the cost of our donor's meds. I have since mentioned his offer to multiple people in the practice, and they all nod their heads like it is standard practice or something. Briefly that would make me feel better, but now after reading your story, I'm nervous again. I'm pretty tight with my nurse there, so I might ask her for guidance.

Aside from my rambling, I am PISSED for you. I know they want to make money, but c'mon. Even with any version of the x3 cycle, they are going to make cash on average. It would be nice if they at least made an effort to make you feel like they actually give a damn about getting you pregnant and not driving you into the poorhouse doing it.

My faith in your RE practice will only be renewed if the Doc calls you himself tomorrow and offers to go to bat with the Financial Committee. That's the RIGHT thing to do. I'll have my fingers crossed for you.

Ann said...

I am so, so sorry you have to go through this. I hate how with medical situations, you only find out the shitty stuff after you invest tons of money. Give your doctor HELL if he reneges.