If you are doing monitoring at SG - before of illiegal billing practices

[Anonymous]

I am doing monitoring at SG and doing my IVF cycle at CCRM.

SG was trying to charge me the cash price for monitoring > $600 for each u/s and b/w even though they take my insurance, and it's considered in network. They said that since I am doing my IVF cycle somewhere else, I needed to be charged the "outside patient" price.

This violates their contract with the insurance company and not a legal practice and when I brought this to their attention, they said that they would only charge my $40 co-pay which is what they were supposed to do in the first place. I am really upset at SG that they made this part of the process so stressful - they are greedy bastards!

SG will also NOT do ultrasounds on you once you become pregnant so don't count on them to do your 6w5d u/s - be sure to be plugged into your OB for your 1st u/s.

[Anonymous]

I just talked to the billing people in Rockville about this issue, since I will be cycling elsewhere, doing some monitoring at SG, and didn't want any surprises on the billing front. My new clinic does not take my insurance and therefore my benefits are still directed to SG. I was told that I will only need to pay my co-pay for monitoring based on my insurance provider - Aetna - and that other insurers require SG to handle monitoring payments differently. In some instances, the insurer indicates that the patient pay out of pocket for monitoring - I am guessing particularly if your benefits are directed to another clinic and therefore technically make you an outside patient. Also, some offices don't have tenured financial people and they may not know the ins and outs of the various providers, so it's easier to fallback on the universal "outside patient" price.

While I don't have direct feedback from my SG RE about OB u/s if I do get pregnant on this cycle, I do know others who have had their OB u/s done there after cycling elsewhere. I don't think it is a general policy to do them - as in you just call up and go in to do it with the doc of the day - but certain REs may be willing to do them for patients who ask. If you spoke to a nurse about this issue, then I would reach out to your RE directly and confirm if HE/SHE will do it for you.

[Anonymous]

Op, it sounds a little harsh to allege illegal billing practices, when it sounds like they corrected whatever was wrong when you talked to them. People make mistakes.

[Anonymous]

Interesting, I used SG about 4 years ago for monitoring and went to Cornell. I had similiar experience to OP, I never questioned it. I also had the problem where they wouldn't do the US. They didn't let me know this up front, they probably assumed I wouldnt get PG since they had failed 5 times before I went to Cornell.

[Anonymous]

8:52 poster - if you still have access to your EOB to your insurance company, Shady Grove needds to reimburse you the difference between the "outside patient' cash price and what was negotiated by the insurance company. There could be a difference of $450-$500 per monitoring appointment.

[Anonymous]

Just wanted to chime in that I too was told that it is against SG policy to do OB ultrasounds on outside patients. My doctor made an exception for me - but he was doing us a big favor. I have to say I can't really blame them for this policy. In our case, it ended up being a tricky situation because the doctor doing the u/s wasn't "our" doctor anymore and felt like it couldn't/shouldn't give us medical advice even though we had some difficult to interpret ultrasounds [our first u/s showed one sac at 5 weeks, our second at 7 weeks showed 2 sacs and two heartbeats with a possible third sac that later turned out to be a hematoma].

As for the billing you as if you are out-of-network, I experienced that too and agree that it is sketchy and in hindsight I probably should have fought it.

[Anonymous]

Gah! I am getting ready to do a cycle at Cornell after not having success at SG. I am planning to do all of my monitoring in NY, so not as concerned about the monitoring bit. But, I didn't realize they wouldn't do an OB u/s. I love my doc at SG and would only want him doing an u/s locally, as I barely know my OB. I will have to ask (beg!!) him to do u/s if the cycle works, as I don't fancy trekking up to NY. To the PP with twins, I will be emailing you, as we know each other

[Anonymous]

I showed up at SG for an 6w5d u/s and they did my b/w but refused to do my u/s. There was no notice given at all - I had even told the appointment desk that this was a 6w5d u/s for a cycle done somewhere else. They referred me to an offsite radiology center which had never done an early pregnancy u/s before - I think it was SG Radiology. It took over 2 hours to establish that we had 2 heartbeats and 2 sacs. I wish that I had known this upfront as I would have scheduled an appointment with my OB.

As far as monitoring appointments, I was given the same information about the "outside patient' price. I had to get my insurance company, UHC, involved who said it was against their contract with SG. Macy told me that the head of their billing/insurance department said they would make an exception for me, and they ended up charging me the $40 co-payment. SG would not budge until I made a formal complaint with UHC which seemed really shady to me.

The whole experience left a really bad taste in my mouth.

[Anonymous]

Has anyone used another local clinic - like Dominion Fertility or GW - for monitoring for an out of town cycle? If so, I was wondering if they charge more than $600 like Shady Grove? Thanks.

[Anonymous]

I used Dominion for my monitoring during an out of town cycle. Dr Gordon is wonderful. He said they would do whatever I needed them to. He even did my ultrasounds after I got pregnant. He really is a great doctor and they run a very nice practice. As far as the billing goes, they billed me the same as if I were coming to them for the full cycle.

[Anonymous]

Yes, I know that Dominion will do it because I have had friends look into going there for the exact same reason.

But you might just want to look into going to Dominion for the whole shebang...

They got me pregnant with b/g twins at 42 years of age!

[Anonymous]

Just curious if Dominion will monitor for other clinics if you have never been a patient there yourself or whether they do it for their former patients only.

[Anonymous]

SG is a ripoff!

[Anonymous]

Anonymous wrote:I am doing monitoring at SG and doing my IVF cycle at CCRM.

SG was trying to charge me the cash price for monitoring > $600 for each u/s and b/w even though they take my insurance, and it's considered in network. They said that since I am doing my IVF cycle somewhere else, I needed to be charged the "outside patient" price.

This violates their contract with the insurance company and not a legal practice and when I brought this to their attention, they said that they would only charge my $40 co-pay which is what they were supposed to do in the first place. I am really upset at SG that they made this part of the process so stressful - they are greedy bastards!

SG will also NOT do ultrasounds on you once you become pregnant so don't count on them to do your 6w5d u/s - be sure to be plugged into your OB for your 1st u/s.

Do you have your facts right? SG did ultrasounds on my until 9 weeks, at which point it was more appropriate that I head to my OB anyway. And since you're not pregnant yet how do you know this?

[Anonymous]

Looking for a clinic to monitor me while in DC for 1 week prior to my FET cycle at CCRM. I'm staying at the Weston in Arlington so by mapquest I see two possibilities Columbia Fertility Assoc and Domnion Fertility. The first is closer but I haven't heard back from them and I called/emailed 3 days ago. any recommendations, I only need a baseline ultrasound and hormone levels.