Gotta Love a Good Mix-Up [Updated]

After a frustrating afternoon at work, I was beyond excited when my husband told me he had not yet checked the mail. (FYI: I love checking the mail - it is an unexplainable passion of mine - but lately hubby has been stealing the daily trip to the mailbox because he is home during the day.) 

Today's trip was one I would have preferred to miss.

Like I said, frustrating day at work. All I wanted to do was come home and cuddle with hubby. Instead, I got to spend far too long on the phone trying to figure out why the fertility clinic sent me a $700 bill when I have already reached my deductible for the year.

The first thing I did was call the fertility clinic. I explained my financial responsibility, according to my insurance, and questioned the bill. The response I was given was upsetting: the paperwork on file does not report I have a deductible; as far as the clinic is concerned, I am responsible for 50% of everything. When I expressed my confusion, I was told that often infertility benefits are lower and to check with my insurance company.

Questions started running running through my head as soon as I hung up the phone. Like: Why was I never informed that my infertility benefits were different from my regular insurance? (I have checked all of the paperwork I received - it says nothing about infertility.) And: Why, if I am responsible for 50%, am I getting a bill for $700 when I have already paid my half?

So I call the insurance company. After being transferred to the wrong person and then forgotten about, I finally got someone on the line who could answer my questions. The end result of a very long and complicated phone call is simple: Whoever processed my initial paperwork made one crucial error - they asked the insurance company for my infertility benefits. So far, all that has been done is testing. Diagnostic testing, according to my insurance, is completely different from infertility (even though we are in search of a diagnosis related to infertility). This makes sense: at our initial consultation, our doctor told us we were dealing with RPL (recurrent pregnancy loss); the office has even been coding all the claims as 'testing' not 'infertility' (minus one - but I had a different doctor, who was unfamiliar with my case, perform my HSG).

Long story short: the fertility clinic has been charging me based on my infertility benefits when they should have been using my regular insurance. Luckily, the insurance company got it right (minus the HSG charge, which they are going to send back to the doctor for review). Now I get to call the clinic back and explain to them they are not allowed to ask for anymore of my money ... and they had better code my upcoming hysteroscopy correctly so I am not asked to pay 50% of that.

[Update: The doctor's office is working things out with my insurance company. I was told that, as long as my hysteroscopy is coded correctly, I should be free of any financial responsibility for the remainder of 2011. The official, final decision might take 3-4 weeks to make, but until then - no bills!]