Insurance Question After a Loss *TW for loss/pregnancy/LC*

[smores]

I'm not sure if it's necessary, but I do want to TW for loss, pregnancy, and mention of LC. 


Hi everyone! I hope that it is appropriate for me to post this here. In February I found out I was pregnant and obtained a referral from my primary care doctor for my prenatal care. At my first OB appointment in early March they told me the baby was measuring a little over a week behind. At that initial appointment (let's call it "Appointment A") they did urinalysis and the standard ultrasound, pelvic exam, all "normal" things. I was in limbo for a week then went back for another appointment where my miscarriage was confirmed (let's call this one "Appointment B"). At this appointment they did an ultrasound. My D&C was completed 2 days later. 

I know insurance is so different based on individual plans. For a little reference, when I was pregnant with DD I paid one $25 co-pay at my initial visit. Everything/all prenatal care was covered 100% with no additional copays. I have not changed insurance. 

In March I paid the initial $25 copay when I went in for Appointment A. 

Yesterday, I received a bill from my OB's office for:
 -$20 charge to me/copay for urinalysis during Appointment A
 -$50 charge to me/copay for the follow up ultrasound and exam during Appointment B


So far, I hope I explained everything so that it makes sense. My question is, do you think those charges were a billing error and should have been covered under my prenatal care? Or is it not outside the realm of possibility that they billed me for those items because the pregnancy ended in a loss... and so it was not considered prenatal care? 

If it's probably an error I will absolutely call them to correct it, but I'm just really not in a head space right now to call and have to argue with anyone about how I think it should have been considered prenatal care even though my pregnancy ended in a loss. 

[oldbaylover1024]

I'm so sorry for your loss.

As far as insurance goes, it's so plan specific. I know you're not in a headspace to call (I wouldn't be either), but you may need clarification from your office.

I don't think your loss has any effect on how your care is categorized. It should all be prenatal care as far as I know. The $20 copay may be for the lab work, not the visit. And the $50 charge may be for the u/s, not the visit. I also see your DD was born three years ago. Even though you have the same provider and same 'plan', there may be changes regarding lab analysis and additional u/s coverage.

I think your best bet is to call. The good news is representatives are usually very considerate - I had to make some phone calls like this after my D&Cs and the representatives were always very considerate of my mental state/the sensitivity of the call. Or call your OB's office to discuss. They should know about your coverage (to an extent).

Again, I'm so sorry for you loss.

[smores]

Thank you oldbaylover1024 and enchanted. You are both right, plans are so specific, I just need to call them. I'm going to call my insurance company first to make sure I'm informed about what should be covered. Then if it does seem like an error after taking with the insurance company, Monday I'll call the medical group that does the billing. If it seems like they want to dig their heels in I'll pass off the phone to MH, who is typically much calmer about this sort of thing. I'm the one that tends to get emotional and take things personally, even if I know they really aren't.

Thanks again for the replies and advice!

[Atpeace]

smores, Something similar to this happened with my second loss. All of my prenatal appointments with that pregnancy got classified as "other maternity services" which went towards my deductible. According to the billing specialists, prenatal care was covered only when resulting in a birth - then all the doctors fees for the prenatal care were recouped under the delivery charges.

It was shitty, but I couldn't do anything about it.

[muscari]

Jul 2, 2017 9:17:34 GMT -6 Atpeace said:

smores , Something similar to this happened with my second loss. All of my prenatal appointments with that pregnancy got classified as "other maternity services" which went towards my deductible. According to the billing specialists, prenatal care was covered only when resulting in a birth - then all the doctors fees for the prenatal care were recouped under the delivery charges.

It was shitty, but I couldn't do anything about it.

Ugh that is just so totally ridiculous! So technically if you have a loss lateron, they could send you a bill for prenatal care and appointments that were already covered but then in hindsight suddenly fall under "other services"? Talking about an extra kick in the teeth! So sorry that some of your insurance plans are so shitty when it comes to these things *hug*

eta: I'm in Europe and insurance is arranged differently here, the US system just confuses me so much!

Also smores I'm sorry you are dealing with insurance crap on top of an already crappy and sad situation. Much love to you.

[smores]

Thanks ladies. Atpeace that is exactly what I was hoping it wouldn't be, but I have a feeling that's exactly why they billed me. I decided to push the call off until after the long weekend.

Thanks again for the advice!

[Nymeria]

smores - With my insurance, even though everything was covered for my pregnancy and it resulted in a live birth I still had a couple copays I was responsible for including bloodwork and an u/s. Because of this I would think it's not out of the realm of possible that you will be responsible for some copays, regardless of the outcome of the pregnancy. Insurance coverage can change too, so even if it was the same insurance as when you had your DD, exact coverage could change a bit from one year to the next.

I know how you feel. I was on a high deductible plan during my loss and had to pay OOP for every beta down to zero and both u/s. I'm sorry for your loss and that you need to worry about this. Going through a loss is bad enough without later getting and having to pay bills for it.