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Nope, you are completely incorrect -- because the condition of infertility can be a result of endometriosis, amenorrhea, oligomenorrhea, and tons of other easily treatable diagnoses which should all be worked up -- even if the woman wasn't coming in for infertility. There is nothing to suggest healthcare fraud. Secondly, the terms of my insurance plan do cover limited infertility treatments up to 4 IUIs and most medication. If the insurance company felt that needed to be cut out of the coverage it's their call, not yours.
Saying there is fraud is like saying somebody had a condition that they did not have at all, and on top of it not providing medical services but billing for them. We do not need people without medical training to start defining fraud and what insurance should/shouldn't cover. You are basically telling women everywhere that they are committing fraud for seeking help regarding pelvic pain, irregular periods, anovulation, potentially blocked tubes / potential gyn infections, potential anatomical defects of the reproductive system, endometriosis, hormonal disorders, brain tumors causing hormonal disorders, and a slew of many other ABNORMAL things. If this is fraud then working up everything else would also constitute fraud - from the common cold to cancer.
Almost 20 years in health insurance, I think I know what I am talking about.
Your initial post CLEARLY encouraged her to have her doctor code it as something else. Don't backtrack. Improper coding = fraud.
Being a mother was the only dream I ever had in life, a dream that now cannot come true.
Sometimes the Universe tells us, "No". And It usually tells us no for a reason. You haven't found out the reason yet. I didn't catch how long it's been since you found out you can't have children, but it sounds like it's recent.
Give it time. Get counseling. Talk with other women in the same position. Mourn the children you will never give birth to.
And, please, give it at least a year before you make any decisions.
I may be having my first child but I have been a parent longer than that. Been raising my step son since he was 3 weeks old he'll be 3 in August. So i have a bit of experiance here. Your right on I am 20 years old and KNOW that I would be a GREAT single parent. Key word there is I would be a GREAT PARENT. Regardless if I had a man in my and my childs life or not. So maybe your insecure of your parenting where you feel you needed a man?? IDK but just because you couldnt do it all that well doesnt mean I cant.
Oh and be glad Im not Hopes or I would jump on you about spelling pregnant wrong.
So you were 17 and started taking care of a baby full time and got custody of him? Interesting. You said earlier in the thread that you got a full ride and went to college? Also interesting.
Yes, I need a man. You solved my mystery for sure. Holy hell are you a child. My sons are both grown, both educated, both successful men and very productive members of society. I think I am quite secure in how they were raised.
Sometimes the Universe tells us, "No". And It usually tells us no for a reason. You haven't found out the reason yet. I didn't catch how long it's been since you found out you can't have children, but it sounds like it's recent.
Give it time. Get counseling. Talk with other women in the same position. Mourn the children you will never give birth to.
And, please, give it at least a year before you make any decisions.
It was confirmed for sure (with the exception of IVF) 2 weeks ago. My doctor suggested that last fall, but sent me to a fertility doctor to confirm.
But I had suspected for many years that I would never be able to because I had tried for 10 years with the only "success" being one miscarriage.
At least 50% of their friends won't have one of their biological parents living with them.
And what a kookie mentality...I want a dad bc everyone else has one! Ok...I'll buy that a kid will say that. Then it's everyone has a phone. Everyone has a new car. Everyone has...using this type of logic is no way to raise a kid and following this mentality is no way to live in the world...everyone is always going to seem to have something more or better.
The answer isn't to make sure that your kid can 'fit in' based on his possessions; rather teach him the value of the things he DOES have and not to place his self-worth on objects outside of himself.
Frankly, I think the odds are stacked against anyone who is a single parent just because a helpful and loving partner makes things so much easier. But not every couple is made up of two loving, committed partners. Or two good parents. I wouldn't do the kid on my own...I just don't think I have the strength or energy or time.
It was confirmed for sure (with the exception of IVF) 2 weeks ago. My doctor suggested that last fall, but sent me to a fertility doctor to confirm.
But I had suspected for many years that I would never be able to because I had tried for 10 years with the only "success" being one miscarriage.
Two weeks! You just got hammered on the head if this is something you always wanted.
Please, find a group of women who are going through the same thing. You need to find women who know exactly what you are feeling. A message board like this is not the place. (And we give great advice. But you need a specialist.) Your fertility doctor should be able to help you. If not, use Google to find a group in your area.
And a year. It takes a year to even begin to get over a loss of any kind: a spouse, a leg, the children you will never have. A year. Anything less and you will be making decisions based on the ache in your heart and that never works out well.
My workplace is a top notch hospital with private operations, and financially they can absorb the extra cost as a favor to their own (since we are seeing their staff and they have their own labs etc).
They "absorb the extra costs"? Are they for-profit? If they are a for-profit hospital somebody else (like the regular ol' patients) are paying $5.00 for one aspirin to supplement all this generosity.
Please. Correct me if I'm wrong.
(Dang. Dad was right. I should have gone into medicine.)
Almost 20 years in health insurance, I think I know what I am talking about.
Your initial post CLEARLY encouraged her to have her doctor code it as something else. Don't backtrack. Improper coding = fraud.
If she has PCOS she very likely has irregular periods. Examples that I brought up would be examples of correct coding in that instance. Seems like she already got the workup anyways. Workup is ALWAYS indicated. It is her doctor that has to determine what diagnosis to put down based on her symptoms - I was just giving examples of what the diagnoses I was given. But there are many, many diagnoses that could be used legally for initial workup depending on the presenting complaint, certainly not limited to the things I listed.
Obviously health insurance people are not qualified to make medical diagnoses. Health insurance bureaucracy/inefficiency is one of the things that drives up cost of health care, so please do not even start talking about the rising cost of healthcare. For profit insurance companies should really be axed instead of having people pay premiums to sustain this industry - and ideally all your middleman colleagues would be out of a job.
Last edited by miyu; 04-13-2011 at 05:34 PM..
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