Tuesday, January 5, 2010

Hmmmmmm....

I really should be working right now, but I have some down time to post really quick.

Yesterday afternoon (01/04), Bar.bara from Dr. Charles' office called to see what my decision was, did we want to do the procedure, etc. I told her yes, but as their policy sates, we must pay $3500 the day of the surgery. She went on to tell me that they changed the price of the TAC because it is no longer being done at the hospital, but in a new surgical center. Th price is now...... $2500. Wow. I stated to her that if that was the case, we could book the surgery right then. SO as of yesterday afternoon, my LAPTAC is scheduled for Tuesday February 16th, at 7:00 am in West Palm Beach, Fl, about an hours drive from my city. To say I am nervous is the least. I keep hearing the "chatter" about the possibilities of LAPTAC's failing. However, I do know that the expertise of the surgeon plays a huge role and Dr. Charles is considered the expert in LAPTAC's. I also e-mailed a few of the ladies on Abby Loopers who had this Dr, place theirs, and got only rave reviews. As, usual, I digress.

I inquired about the refunding of my money when it is all said and done, and she proceeded to tell me, that even if the money is not refunded, a bouncing baby is priceless. Yeah, she's right, but I want my money back. Many of the ladies that I spoke to do get their money back, so I better get my money back. Then, I asked her for the procedure code, tax id, the works. To my astonishment, she said that here is no procedure code. Huh????? I asked her, "then how does the insurance company know what they are paying for?" She said that when the surgery is done and they request payment, they tell them it was a procedure done to the uterus. No wonder they have a hard time getting the insurance companies to pay for the procedure! I decided that I am not taking that risk! I do not have to go into the whole I am a teacher, and we do not get paid two and a half months out of the year, and I need that money spiel in order for you all to understand, because I know you already do.

Knowing how I hate spending money, one of my coworkers who I am really close to, told me of a lady she met at a union event. This individual works for vista (on of the head honchos) and is able to get procedures approved when all other methods fail (I wish I had known this when I had the procedure scheduled with Dr. Davis, but now that they now someone is in network that does it, they are sure not going to approve an out-of network procedure).
I got her number and called as soon as I had a 15 minute break. She explained that there should be no problem getting the insurance company to pay for the procedure. She called Bar.bara with me in the phone and inquired about this. Bar.bara replied that she faxed over the request and it should explain it all. The lady a Vista, said if they paid him in the past (for the consultation) then there should not be a concern about payment in the future. She did say though that the approval may take time, because it is not an emergency, but I should call her back in two weeks If I did not hear anything.
The things that make you go hmmmmm...... It seems as if 2010 is starting out right after all. What a way to start my season.

Awaiting my expected end.

11 comments:

  1. Marie, that is such good news!! There is a code for a TAC by the way...I have looked for it. I can't believe the doc office said otherwise. You can google CPT code for Transabdominal Cerclage and it will come up. I'll be praying for you.

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  2. I'm excited to hear that things are moving along and that your surgery is scheduled. I'll be praying that the surgery goes well and that your bouncing baby will be in your arms by the end of 2010 :)

    Is there a waiting period after the surgery before you can start TTC?

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  3. Awesome news on all fronts. Also great that you won't have the additional travel expenses you would have incurred had you gone to Chicago or New Jersey. :)Love the new blog look.

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  4. Marie, I am glad to hear the good news for you!!!

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  5. I'm so glad your finally getting some good news!

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  6. I might need that Vista connection # some day!! ;)
    Glad things are off to a great start in 2010!

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  7. Oh Marie that is wonderful news! I am so glad you have got someone on your side at Vista! Good Luck!!!

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  8. Wow that is so exciting!!! Hooray for 2010!!

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  9. Wow! Things will be moving forward sooner then! How awesome that you have to pay a thousand less up front.

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  10. Marie,

    New to your blog and just wanted to stop in and send you love and prayers during your upcoming procedure. I'll be journeying with you and following your road to success. I BELIEVE in HOPE and I believe in FAITH and I believe "he" believes in us.

    Many Hugs,
    Andrea
    persuitofourfairytale.blogspot.com

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