Is CCRM Billing Really Bad?

[Anonymous]

Pretty early in my fertility journey and chose CCRM based on reviews and SART data. I called before I made my first appointment and verified that both the physician and the lab were in-network. This is also reflected on my insurance website. CCRM did a call with my insurance that seemed awesome. They went through every procedure code and verified whether it was excluded from coverage and whether prior authorization was needed. They concluded that I have IVF coverage with no prior authorization. I personally verified this with my insurance.

I had to wait six weeks for an appointment. I had an appointment, and it went really well. Several weeks after my first appointment and after I'd done several tests, I got assigned to a finance counselor who informed me about all kinds of "non billable" and "out-of-network" charges I'll incur. Even though my insurance covers PGT-A testing, they say that CCRM's PGT-A testing is "non billable," and I'll need to pay thousands in cash up front despite the lab being in-network. I'll also need to pay other non-billable things like "coordination fees" in cash up front. The finance counselor then incorrectly told me that my insurance requires prior authorization and that she'll be working on submitting it. When I followed up about all the contradictory information and how these charges could be permitted the the lab and provider are in-network, I got a word salad non-response.

I'm starting to get anxious. I'm on a tight timeframe (moving for a temporary assignment many states away) to freeze these embryos and feel worried that it's too late to change clinics. But this financial stuff feels sneaky and also like I'm going in blind. I don't know if I'm going to pay $300 for IVF or $30,000+.

Anyone have a similar or (hopefully) better experience with CCRM?

[Anonymous]

I've been with 2 clinics in this area - CCRM Nova and Dominion Fertility. I thought DF's billing dept was bad, I didn't know how lucky I was until I came to CCRM Nova. CCRM made an already stressful situation much worse. Some things are out of network despite the clinic being in network.

With my situation (DOR, egg quality issues, AMA, etc.), DF just couldn't help me anymore after I had my first baby with them. CCRM was able to help me have my second baby, so I would still put up with their billing because I had more success with them.