Tuesday, March 14, 2017

Lesson learned: Don't have a baby in Australia pt 2

So here's what I knew about having a baby in Australia by the time I went to my first appointment with an OBGYN:

1. A doctor had to refer me to the hospital in order to meet with doctors at the hospital.

2. I needed to get a form filled out by my doctor so that the insurance company could arrange for the hospital to bill them directly for the costs of my appointments and I could stop having to file claims and wait for reimbursement.

3. Uhhh that was about it. That's all I knew at this point.

I just knew that I was approaching the tenth week and all I had done to ensure the health of my baby was take prenatal vitamins and had some blood work done. I wanted to meet with an OBGYN because, as anyone who knows me will be unsurprised to hear, I had a million questions and wanted to talk to someone who knew the answers. Tyler and I went to a obstetrics office just across the street from the hospital to meet with a doctor that was on the list of OBGYNs that work at the hospital. I wasn't entirely sure what the difference was between meeting with the doctor at this building versus the building across the street, but I didn't want to wait any longer to speak with an expert and just make sure everything was ok in there.

The OB was delightful. He was very helpful, did not rush us at all, entertained all of my questions and did a quick ultrasound to show us the proof that there was in fact a baby cooking up. It was lightyears more comforting than any of the appointments I'd had in Kuwait with our first pregnancy and I was so glad to feel at ease and supported as a woman who advocates for her own health. At the end of my litany of questions I asked, "So, how does all this work?" meaning how does the whole having-a-baby-in-Australia thing work.

The doctor said that there were a couple of options. I could go the public route and I could meet with a doctor of a midwife at the hospital. Or I could go the private route, I would meet with an OBGYN in an office and deliver at the hospital of my choice.

So, like, the hospital right there? I thought to myself.

Then there was shared care, where I would meet with the OBGYN at his office for all the pre-delivery appointments and then go to the hospital for the big event and deliver with whoever was on duty at the time.

I asked a few clarifying questions. If I went the public route would I have him as my doctor? He explained that I would likely meet with a different doctor or midwife at each appointment and when it came time to deliver I would be helped by whatever doctor was on duty that day. That didn't sound too crazy to me, I'd heard about similar things happening in other countries with public healthcare. I liked the fact that I could choose to be delivered by a doctor or a midwife and that a birthing center and a team of midwives was attached to the hospital and was also a possibility for public patients. That's a luxury in most states back home, so I was impressed with how progressive healthcare here was.

If I went the private route I would have the same doctor for each of my appointments and that same doctor would deliver me at the hospital when it was show time. That also sounded nice because, as a Woman of Large Size (a term I've made up to say that I'm fat), I was concerned that meeting with a different doctor each time could lead to some obesity-related complication getting missed. I also liked the idea of being able to communicate my birth plan to one person and having it agreed upon well before the due date rather than having to possibly negotiate things while in labor.

So my understanding when I walked out of the consultation room was that I would have choices. Choices are nice. I like choices. Ultimately I didn't really care which choice we went with because they all made me feel comfortable about this whole giving birth thing.

Aaaand then I got to the reception desk to pay the bill. After the nice lady got over the shock that I didn't have a medicare card, she handed the bill. Thankfully I was working full time at a school and getting a full teacher salary and had just had a pay day because WOW the bill was not just $50! I tried to hide my sticker shock when I was handed the invoice and told that I had to pay before leaving. Tyler and I exchanged a couple panicked looks as we both did some mental math to see if we could still afford to eat that night and when the receptionist came back from processing our payment I asked, "So, um, how can I find out how much all of this is going to cost, just so I can budget and make sure we can pay at each appointment?"

I was handed five pieces of paper, all of them with a chart with lots of numbers and was told it would depend on what my insurance would cover, but essentially it could cost nothing or upwards of TEN THOUSAND DOLLARS!

"Wow. That's quite a spread." I said mostly to myself.

"Yeah, you'll need to get in touch with your insurance right away because it can take a long time for all of that paperwork to process and until that is worked out you'll be responsible for paying for each appointment."

I knew what that meant. I was in for many more phone calls to our insurance and much more frustration, and the insurance company did not disappoint. Once again I connected with various call center employees and once again I was told, "That is confusing, you must be frustrated."

Tyler was able to find a living human that he could meet with face-to-face and she was VERY helpful and actually empathetic to our situation. She explained that that form we'd been told about not only arranged for the hospital to bill the insurance directly, but it would also allow the insurance company to basically negotiate a public relationship with the hospital so that we could choose to go the public route and essentially pay nothing for the whole thing.

I like paying nothing. Let's pay nothing. We would get the OB to fill out the form at our next appointment. I had my 12 week ultrasound a couple weeks later and would meet with the doctor again after the results came in.

You all know how that 12 week ultrasound went. That was when we told my parents that I was pregnant and got to see our little guy or girl swimming around in there. I continued with our vacation and about a month later, after my parents had gone home, I realised that I hadn't heard anything about results from the ultrasound. According to our Australian friends, that's how things work here, it's up to the patient to call and find out about results, but generally no news was good news. I went to my second appointment with the OBGYN and was glad to hear everything looked good. I got the form filled out and I made my appointment for my 20 week ultrasound.

It all was going swimmingly! We had taken care of the paper work and was waiting for the insurance company to do its thing. The 20 week ultrasound went well and I had my appointment for my third meeting with the OBGYN, but all indications were that the second ultrasound showed no defects or reason for concern. I was nailing this whole being pregnant thing!

And then, of course, it hit the fan. I had started a new teaching job and it was during a planning period that I got a phone call telling me that at my next appointment I would need to pay my management fee.

"Ok, and how much is the management fee," I asked.

"Well, depending on your insurance, it'll cost $4,000 or $5,000," she calmly said like that was a completely normal amount and shouldn't shock me.

To be continued...

Vicariously yours,

1 comment:

  1. Wow.that is phenomenal.hopefully your insurance covers some of it .catch ups soon xoxoxo ��