Thursday, June 10, 2010

Salt in the Wounds

I've learned a lot over the past few weeks about the medical billing world, and none of it is very pretty. It all started when I received a lovely little letter from our insurance company regarding my hospital stay and Benjamin's delivery. It said:
Based on our review, this service or supply is not approved because it does not satisfy the criteria for establishing medical necessity and appropriateness... No benefits will be provided...

Translation: You're about to owe over $10,000 in medical bills for delivering a child you didn't even get to keep.

Now, I know that I had the option of staying home and going through the entire, um, process, alone, but after having been there, done that, I can assure you, every bit of my time at the wonderful St. John's hospital was medically necessary. I guess if I were one of those women who opt for no pain meds, no epidural, water births, or whatever, maybe I could have pulled it off. But then again, remember the whole possibility of "uterine rupture" or "necessary C-section?" I don't know that Jason and I could have handled that by ourselves in our living room.

So, I called the insurance company, hormonally poised to shake someone silly through the phone lines, when I was dealt with yet another blow. The helpful agent explained to me: "This procedure is not covered because your medical records indicate that you had an abortion."

Excuse me, what!?

I quickly and emphatically explained to her what really happened, you know, the ultrasound that rocked the world. And that's when she explained further: "I'm so sorry that happened. But unfortunately, the medical codes are the same for a miscarriage as they are for an abortion. All the code says is that a pregnancy was terminated. It does not distinguish whether the termination was voluntary or involuntary."

I'm sorry, but I'm just a little bit floored that in the decades of modern medicine, no one thought to distinguish between two such drastically different circumstances. I wanted to insist someone from claims call up Nurse Cameron and let her explain the midnight duet between the Doppler machine and my stomach that medically confirmed - for the third time - that our child was not "aborted" in the typical sense of the word. Did his life end abruptly while still in the womb? Yes. But his days were numbered by God Himself, and it just so happened that that number was very small.

I'm not worried about the financial aspect of it all. To be honest, I know that if God can handle the people at David's Bridal and protect me from having to buy bridesmaids dresses in bulk, then He can more than handle a little medical claim gone askew. It's just the principle of it all. Because of this stupid glitch in the world of medical billing, the burden is on me to provide my entire medical record to my insurance company in order to reopen the claim and have the insurance applied.

That, and now it's "out there" that I've had an abortion, even if it isn't true.

I remember reading Sarah Palin's memoir, Going Rogue, in which she tells that she went through something very similar. When running for Vice President with a Pro-Life platform, someone somewhere dug up her medical records and reported that this Pro-Life candidate had had an abortion in her past.

Not true.

Like me, she'd experienced a miscarriage, and like me, the medical coding associated with it did not distinguish between a voluntary termination of a pregnancy or an involuntary termination. On paper, the pregnancy was "aborted" and the details associated with it were buried beneath the codes.

It makes me sick and it makes me mad that somewhere out there someone could argue the same against me. In those circumstances, the truth usually does come out loud and clear, but it's like printing a retraction on the bottom of the last page of the newspaper; the damage is already done.

I don't like having my name associated with an "abortion" even if it is a medical term and even if it is synonymous with miscarriage. I have many, many friends who have had abortions, and I know the pain and regret they have had to work through. It's not that abortion is unforgivable or that it's any more heinous than any of the awful things I actually have done; it's just that I don't want anyone anywhere to ever have reason to think that I didn't want my sweet Benjamin.

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