Please read the important information below about the submission of insurance claims.
1. Predetermination letter/packets are no longer being sent out. We have found through past experience when the insurance companies receive the "predetermination" information for IVIG therapy the patient's claims are red flagged and benefits usually denied. Our patients have had better success in having these services paid for when they just submit the claim for payment.
2. If a patient receives a denial of benefits, they can send it to our office and we will then draft a letter of medical necessity. There is a $75 fee for a letter of medical necessity. Please note: no letters of medical necessity will be issued without our office receiving the written denial from the insurance company.
3. We will not negotiate discounts or "insurance only" payment arrangements. It is your responsibility to ensure that you have sufficient insurance coverage or the personal economic means to pay for your services.
4. Our office will not submit claims. The patient should remember that it is ultimately their responsibility to pay for professional services rendered and charged to them. These services will become the financial responsibility of the patient. Patients will be required to pay the full charges shown on his or her fee slip at the time of service.
5. If the patient's health insurer subsequently pays for services directly to to our physicians, we will return the payment to the insurance company and ask the insurer to send the check to the patient.
6. We will not continue to "fight" with your insurance company, regarding your coverage, after initially providing reasonable scientific information to support your treatment. Couples afflicted with infertility or pregnancy loss, struggling with insurance reimbursement, soon realize that many tests and procedures associated with their treatment will not be covered. While we will support your efforts to obtain coverage, we cannot provide more than reasonable information to persuade your insurer that these services should be covered.