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Infertility treatment cost can be better controlled when a fertility specialist is consulted early in the infertility evaluation. We are committed to helping couples afford the infertility treatments that they need and controlling overall infertility treatment cost. We do everything possible to control infertility treatment costs and the expenses of ART technologies. Our IVF success rates are typically high meaning fewer cycles of IVF may be required. The same is true for our donor egg program.
The fertility specialists and staff at DFW Fertility Associates believe in offering the most cost effective evaluation and treatment for our patients, regardless of insurance coverage. Coverage, and the desire to control fertility treatment costs, should not dictate less effective treatments. Unfortunately, not all insurance policies cover ART treatments like IVF and there is a wide spectrum of coverage for fertility testing and infertility treatments. IVF and infertility treatment reimbursement vary among different insurance companies and different policies from the same insurance company.
When a person makes a "new patient" appointment with a fertility specialist at DFW Fertility Associates, she will be asked to provide a copy of her insurance card so that we may verify fertility treatment insurance benefits prior to the initial visit. The purpose of this verification is to insure that our patients have coverage for diagnostic testing before any fertility tests are ordered. Tests can be a significant portion of overall fertility treatment cost. The amount of coverage a couple has is dependent upon the terms of their insurance policy. Some policies completely exclude any type off fertility testing or treatment of infertility while others cover IVF costs. The cost of diagnostic fertility testing may be considerable if you are self-pay patient. Fortunately, there are strategies that can be used to minimize some of these infertility and IVF treatment costs.
Although our staff will attempt to verify insurance coverage, patients have the ultimate responsibility of knowing the extent of their insurance coverage. We encourage our patients to independently verify infertility treatment coverage. Sometimes our staff is provided with benefit information, by an insurance company representative, that differs from what the patient's policy actually covers. We encourage all patients to obtain a copy of their insurance policy and to contact their insurance company to determine benefits for infertility and IVF. Questions are often answered by the insurance company representative on the phone; however, the information provided is not binding and we encourage all patients to obtain a written copy of their coverage from the managed care provider.
Fortunately, many patients’ insurance policies cover diagnostic testing. This often includes office visits, blood testing, ultrasounds, x-rays (HSG) and usually outpatient surgery, such as a laparoscopy. .Some policies specifically exclude infertility diagnostic testing. If so, our physicians and staff will try to minimize your out-of-pocket cost by ordering tests in a judicious fashion. Some insurance policies require all blood testing to be conducted at a specific laboratory.
Some patients have insurance policies that cover fertility treatments such as artificial (or intrauterine) insemination, or they cover all, or part, of IVF treatments. Our office will try to obtain written confirmation of benefits covering infertility treatments before you actually undergo the procedures. We will file claims and attempt to negotiate disputed claims with the insurance carrier. However, patients are responsible for payment of charges at the time of service.
Fertility drugs, such as Clomid or FSH, are usually covered by your insurance if your insurance policy also covers fertility treatments, although sometimes they are excluded . Some policies require patients to use a specific pharmacy.
Some insurance policies have a “maximum cap” on benefits, which is one reason a specialist should be consulted early in treatment. Sometimes these limits are annual, for example $5,000 per year; and sometimes they are lifetime, for example $20,000 lifetime coverage. Many patients cannot afford to waste fertility benefits with multiple attempts at procedures that aren't effective. One of our goals at DFW Fertility Associates is to administer cost-effective treatment using the appropriate level of technology.
When advanced procedures, such as in vitro fertilization or ICSI, or Donor Egg are required we work with couples to determine the best payment options. We also accept major credit cards for our patients’ convenience. Payment plans are available through Advanced Reproductive Care (ARC) if the patient or couple qualifies.
DFW Fertility Associates is “contracted” with many insurance plans through System Health Providers Inc. (Genesis), a network management company that negotiates contracts for several hundred physicians as a group in the DFW metroplex. We also contract directly with some insurance companies. A few of the insurance plans with which we participate are listed below:
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Aetna (all plans) |
MultiPlan PPO |
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Accountable PPO |
NHA PPO |
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Affiliated PPO |
NPPN PPO |
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Blue Cross Blue Shield HMO*/POS*/PPO |
NTHN PPO |
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Beech Street PPO |
Pacificare PPO |
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CCN Managed Care PPO |
ppoNEXT PPO |
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Cigna HMO*/POS*/PPO |
Private Healthcare Systems PPO |
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Great West Healthcare PPO |
ProNet PPO |
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Healthcare Partners of East Texas PPO |
United Healthcare (all plans) |
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Humana PPO |
Unicare Performance PPO/Classic PPO |
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IMS PPO |
USA MCO |
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*Karen L. Lee, MD only
Since these contractual agreements have varying expiration dates, you are encouraged to call the office to verify that your specific managed care plan is still contracted with us at the time of your appointment.
Some insurance plans are “managed” meaning that some type of referral or authorization is required before office visits, testing or treatments can be conducted. WHEN A REFERRAL IS REQUIRED, IT IS THE PATIENT’S RESPONSIBILITY TO OBTAIN THIS FROM THE PRIMARY CARE PHYSICIAN PRIOR TO THE APPOINTMENT TIME.
We look forward to helping couples have a child and strive to make sure they understand fertility treatment costs including ART therapies such as IVF. This helps to reduce some of the stress associated with fertility treatments. Please contact our insurance coordinator to learn which therapies may be covered by your insurance provider.
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