Shady Grove Shared Risk Contract
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Anonymous
First post here 
I recently got my approval for SGF Shared Risk Program and wanted to share the terms in case anyone is interested, as I was when I doing my research. FYI, I needed to complete all pre-screenings done before I got the approval. They put all numbers in the computer and approve you if your success rate is above certain %. Hope this helps! (If I'm not allowed to share this here, please let me know. Again, I'm new here) -- Shared Risk Refund Program Information & Participation Agreement Shared Risk Refund Program Deposit Based on Age: <35 $19,500 35-37 $22,500 38-40 $28,500 (PGS is required in this age group & fee is included in the program deposit) Program Riders PGS Biopsy & Lab Analysis Rider $5,000 (A Laboratory of SGF choice must be used for lab analysis to be included in the Shared Risk Program) Gestational Carrier Rider $5,000 PGD Embryo Biopsy Rider $3,000 (Lab Analysis excluded from the Shared Risk Program; patient makes payment directly to the PGD facility) INTRODUCTION: THIS SHARED RISK REFUND PROGRAM was developed by Shady Grove Fertility as a creative alternative to the traditional payment method for medical services and treatment associated with assisted reproductive technologies (ART). The traditional payment method (which is also offered) requires payment for each treatment cycle regardless of outcome. Patients have expressed concern about the cost of multiple treatment cycles and the uncertainty regarding outcome. If patients utilize ART but are unsuccessful in having a baby, some patients may not be able to afford other alternatives such as adoption. In many cases, because of limited financial resources, patients must choose between ART and pursuing adoption. This Shared Risk Refund Program is intended to provide an alternative to this difficult choice. For an agreed upon program fee deposit to Shady Grove Fertility you are allowed up to 6 stimulated IVF treatment cycles and the use of cryopreservation in order to achieve one (1) successful pregnancy which ends with the birth of a live born baby. The Shared Risk agreement is completed with either withdrawal, completion of the 6 IVF cycles (and transfer of any cryopreserved embryos if applicable) or the birth of a live born baby, whichever comes first. If you do not deliver a live born baby with this treatment, 100%* of the program deposit will be refunded to you. We offer this program as evidence that our confidence in our success rates enables us to “share the risk” financially with our patients. This Shared Risk Refund Program is offered selectively to patients who have completed a full medical prescreening and are considered good ART candidates by Shady Grove Fertility. Many health insurance plans cover ART in some form, to a greater or lesser extent. You should check with your own insurance carrier to determine whether or not you are covered for IVF. Shady Grove Fertility may assist you with your inquiry, but we cannot be responsible for determining whether or not you are covered for IVF. Generally, Shared Risk is for patients without insurance coverage. * Some exceptions apply, refer to sections “other considerations” and/or “additional other considerations” ELIGIBILITY: You must be approved to participate in this Shared Risk Refund Program by Shady Grove Fertility. This Shared Risk Program is offered selectively to patients who have completed a full medical prescreening and are considered good ART candidates in the sole and subjective opinion of Shady Grove Fertility and who approve and consent to the medical procedures, techniques and medications that are considered important to success within their IVF cycle. Only patients, and/or couples, in whom the female partner will be able to complete at least one egg retrieval before her 41st birthday will generally be considered. The determination of Shady Grove Fertility is final. The Shared Risk Refund Program was designed for patients with no insurance benefits. However, we do allow patients with insurance to participate in the program. To participate in this program you must waive claim to any health insurance reimbursement and understand that we cannot submit charges to the health insurance company for services included in this plan. Patient(s) acknowledge that they are purchasing a package of services and understand receipt with an itemization list of services provided in this plan will not be issued. Insurance may cover and if so can be used for medications, for prescreening, and for non-Assisted Reproductive Technology (ART) related surgeries, and pregnancy care, if needed. CRYOPRESERVATION of EMBRYOS or EGGS If you elect to participate in the Shared Risk Refund Program, Shady Grove Fertility will cryopreserve embryos, if any, determined by our physicians and staff to be of such quality as to have a high likelihood of survival once thawed and transferred. Shady Grove Fertility will not charge any additional fees for cryopreservation or thawing and transfer of cryopreserved embryos cryopreserved as part of any of your 6 IVF cycles. The embryo freezing and the thawing/transfer cycles are included as part of, but do not count against, the 6 treatment cycles for which this Shared Risk Program was established while the contract is still in effect. Embryo(s) that are cryopreserved or eggs that are cryopreserved for later fertilization and transfer as part of any stimulated IVF cycle under this Shared Risk Refund Program must be transferred in attempt(s) to conceive before commencing a new Shared Risk stimulated IVF cycle. By signing this contract, you agree to cryopreserve your embryos as indicated above and transfer cryopreserved embryos or embryos from fertilized vitrified cryopreserved eggs before commencing a new Shared Risk stimulated IVF Cycle. EXCLUDED PROCEDURES: 1. Prescreening tests (Day 3 Blood work, Mock Embryo Transfer, Fluid Sonogram, HSG, Follow Visits, Semen Analysis, etc.) are not included in the Shared Risk Refund Program. A number of basic tests will be needed for both partners while some additional testing may be required in specific situations and/or between IVF cycles. Refer to the prescreening information sheets for further details. 2. Medications are not included. The estimated total cost is $4,000, per stimulated IVF treatment cycle. Cryo transfer medications costs an average of $400 per cycle. 3. You will be responsible for any hospital charges incurred. All Shady Grove Fertility IVF (retrieval & transfer) procedures are performed at a Shady Grove Fertility facility and there are, therefore, no standard hospital fees. Hospital fees incurred in the rare event of evaluation and hospital admission being needed for a complication of medications or medical procedures such as infection, bleeding or severe ovarian hyperstimulation syndrome. to operative laparoscIopy, Dn&C, cyst andP/or flurid aspoirationc) are eexcludesd. s 4. Any non-ART (assisted reproductive technology) procedures, surgeries, (including but not limited 5. If donor sperm is being used, the cost of the donor sperm samples is not included. 6. All PGD laboratory services (single gene cases) are excluded. There are two components to PGD: The embryo biopsy and the PGD lab analyses. The PGD lab analyses will be performed by and paid to an outside Laboratory and not as part of this Shared Risk agreement. The embryo biopsy fee, if indicated on the first page of this agreement, is included in your Shared Risk Refund Program deposit. 7. If either partner has a balanced translocation they are not eligible to participate in the Shared Risk Refund Program. 8. Once the Shared Risk agreement ends with the birth of a viable baby, thawing and transfer of embryos and/or oocytes, which, while cryopreserved in the Shared Risk Refund Program and to be used to attempt a subsequent pregnancy, is excluded and applicable charges apply. 9. Annual Cryo storage costs of embryos and/or oocytes are excluded, once the Shared Risk agreement ends. 10. All urological procedures and associated surgical facility fees are excluded, whether done at Shady Grove Fertility Center, hospital, or outside Surgery Center. 11. Pregnancy care (blood work, ultrasounds and office visits) is excluded from Shared Risk Refund Program. 12. Sperm Storage is not included in the Shared Risk Refund Program. 13. Fees assessed with Anesthesia services and sedation for an Embryo Transfer is excluded from the Shared Risk Refund Program. 14. Patients requesting a delay in the standard timing of fresh embryo transfer(s) for non-medical indications (i.e. indications not prescribed by the physician; such as travel) and request to cryopreserve all embryos for transfer at a later date(s) will be charged a supplemental fee of $2,400 for each freeze to cover the additional laboratory and medical team expenses. This fee is supplemental to the Shared Risk Refund Program deposit and is non-refundable although transfer of these cryopreserved embryos is within the Shared Risk Refund Program. 15. There are occasionally medically prescribed indications to cryopreserve oocytes (eggs) prior to their fertilization. If, however, a patient requests cryopreservation of unfertilized oocytes (eggs) without a medical indication, then the patient will be assessed a supplemental charge of $2,400 for each such freeze. This fee is supplemental to the Shared Risk Refund Program deposit and is non-refundable although transfer of these cryopreserved embryos that may result after the thaw, fertilization and culture is within the Shared Risk Refund Program. 16. Co-IVF couples – for cases where both partners wish to create embryos the couple would pay for a separate IVF freeze all cycle outside of the Shared Risk program and would be responsible for additional and separate storage fees. Embryos created from either egg source could be used under the Shared Risk program with the understanding that the program is completed with delivery from either egg source. PROGRAM TERMINATION: Shady Grove Fertility believes it is important for the patient to have autonomy to withdrawal, at any time, prior to achieving pregnancy. If you do so you, except as discussed in Other Considerations & Additional Other Considerations below, will receive a full refund. Likewise, Shady Grove Fertility reserves the right to terminate the Shared Risk Refund Program described in this agreement for any reason. In vitro fertilization provides us with important diagnostic information and we learn more about your egg, sperm, uterine and embryo function from each cycle. If you have unsuccessful cycles, this will be reviewed by your doctor and will be used to determine subsequent likelihood of success. It is possible therefore that after unsuccessful cycle or cycles, your doctor will determine that further treatment is unlikely to result in a successful outcome. In this situation of our withdrawing you from the Shared Risk Refund Program, we provide you with a 100% refund of the deposit paid for the Shared Risk Refund Program. As examples, if any of the following conditions become known during the program; participation in the Program can be ended. These include, among others: • Poor ovarian response to stimulation. • Couple’s desire to strictly limit the number of embryos transferred below that which is clinically recommended with or without Shared Risk participation so as to compromise pregnancy rates. • Medical complications or side effects from medication. • Failure of the couple/patients to approve or consent to procedures, techniques or medications that are part of the clinical care protocols considered by Shady Grove Fertility to be important to your success, such as intracytoplasmic sperm injection (ICSI), assisted hatching (AH), and/or cryopreservation/vitrification. OTHER CONSIDERATIONS: 1. If you become pregnant independent of assisted reproductive technology’s treatment provided by Shady Grove Fertility, you will receive a full refund. 2. The terms of the agreement are considered complete with the birth of a live born baby. 3. A cycle which is cancelled before embryo transfer does not count toward the six IVF cycles, however, if during a stimulated cycle it is medically necessary to freeze all embryos or oocytes prior to a fresh transfer, the initial subsequent thaw cycle will complete the cycle attempt and will count as one of the six IVF cycles. 4. A pregnancy loss (miscarriage) and/or delivery of a non-viable infant is considered a completed cycle, but only delivery of a living infant means we have earned our fee in this agreement. 5. If the couple incurs a pregnancy loss as the result of selective reduction of triplets or greater multiple pregnancy, the cycle in which this occurs will not count towards the 6 stimulated cycles. 6. If the couple chooses to terminate the pregnancy for non-medical reasons or loses the pregnancy due to selective reduction of twin pregnancy, the couple’s account will be assessed for the full deposit amount of the Shared Risk Refund Program. 7. If the couple elects not to have a transfer after cycle monitoring, egg retrieval and/or laboratory fertilization and culture, you will be responsible for all cycle charges that have accrued as if that cycle was a non-Shared Risk cycle, and you will be refunded the remainder of the amount deposited into the Shared Risk Refund Program. 8. If substantive historical information and/or medical or laboratory data become available that is discrepant or falsified from that upon which a decision to accept into Shared Risk was predicated, a full single cycle fee for each IVF cycle completed will be charged and you will refunded the difference of the amount deposited into the Shared Risk Refund Program. 9. IVF Cycle converted to IUI/TI Cycle will not count towards your 6 IVF Cycles. However, if pregnancy occurs on a converted cycle, patient will receive 75% refund at time of delivery. 10. Patients monitoring out of state are eligible to receive a $500 rebate per cycle (with prior approval). Rebates will be issued once the Shared Risk agreement has ended with a viable pregnancy or withdrawal from the program. In no way shall the rebate and refund exceed the original payment made by patient. 11. Frozen Embryo Transfer cycles and Egg Thaw-Transfer cycles are not eligible for out of state monitoring rebate. 12. Egg Thaw cycle(s) with fertilization leading to an embryo transfer do count as one of the six available Shared Risk IVF Cycles. 13. Patients using a Gestational Carrier must have their Gestational Carrier approved by a Shady Grove Physician to be eligible and remain in the program. Patient’s Gestational Carrier must match with a Gestational Carrier within 12 months of the egg and/or embryo freeze date or will be withdrawn from the program. If no transfer has occurred within 18 months, 50% of the amount deposited into the Shared Risk Refund Program will be assessed and any remaining portion will be refunded. 14. Embryo Batching; if patient chooses to move forward with a fresh cycle without transferring frozen embryos there will be a $7,500 non-refundable charge. Embryos formed during this $7,500 non- refundable cycle will remain part of the Shared Risk Refund Program. The fee is non-refundable. 15. If you terminate this agreement while you still have cryo-preserved embryos or vitrified eggs obtained through an IVF cycle in the Shared Risk Refund Program, and wish to maintain those embryos or eggs in storage at SGF or at any other storage facility or clinic you will be charged 50% of the amount deposited into the Shared Risk Refund Program and refunded the difference. 16. If you have not selected the “PGS Biopsy & Lab Analysis Rider” and elect to terminate the agreement after an unsuccessful cycle or pregnancy loss and have cryopreserved embryos or vitrified eggs formed during the Shared Risk Refund Program, a full refund can only be obtained if you elect to thaw and dispose of those embryos or eggs. (If you have selected the PGS Biopsy & Lab Analysis Rider refer to section below) 1. Patients selecting the PGS Biopsy & Lab Analysis Rider must agree to allow all mature eggs to be inseminated and all embryos that meet SGF’s criteria for biopsy be analyzed. Biopsied embryos need to be cryopreserved and patient will need to return for a frozen embryo transfer. Genetically normal embryos must be transferred prior to initiating another fresh cycle. 2. Embryo Batching; if patient chooses to move forward with fresh cycle without transferring genetically normal frozen embryos there will be a $7,500 non-refundable charge. Embryos formed during this $7,500 non-refundable cycle will remain part of the Shared Risk Refund Program. The fee is non-refundable; even if all the embryos formed during this cycle are genetically abnormal and not suitable for transfer. 3. If you terminate this agreement while you still have cryo-preserved genetically normal embryos or vitrified eggs obtained through an IVF cycle in the Shared Risk Refund Program, and wish to maintain those embryos or eggs in storage at SGF or at any other storage facility or clinic you will be charged 50% of the amount deposited into the Shared Risk Refund Program and refunded the difference. 4. If couple elects to withdrawal from the Shared Risk Refund Program and has elected to discard genetically normal embryos, in which the couple have been informed of the gender of the embryos, you will be charged 50% of the amount deposited into the Shared Risk Refund Program and refunded the difference. 5. If genetically normal embryos, in which the couple have been informed of the gender of the embryos, are available and patient elects to have the genetically normal embryos discarded, a $12,000 fee for service global fee (IVF/ PGS biopsy) will be required prior to another fresh retrieval. This fee is supplemental to the Shared Risk Refund Progam and is non-refundable; any embryos formed during this non-refundable cycle will remain part of the Shared Risk Refund Program. 6. Additionally, if couple elects to discard genetically normal embryos; in which the couple have been informed of the gender of the embryos, prior to SGFC having the opportunity to earn the Shared Risk fee (for example if patient becomes pregnant and unfortunately has a pregnancy loss and has discarded genetically normal embryos) a $12,000 fee for service global fee (IVF/PGS biopsy) will be required prior to further fresh cycle. This fee is supplemental to the Shared Risk Refund Program and is non-refundable; any embryos formed during this non-refundable cycle will remain part of the Shared Risk Refund Program. ACKNOWLEDGEMENTS: 1. The Shared Risk Refund Program is not insurance. It enables you to fix the cost of up to 6 cycles of assisted reproductive technologies while limiting the payment amount if the procedure is successful after multiple attempts or is unsuccessful. Payment of the Shared Risk Refund Program deposit plus the cost of prescreening tests, medications, hospital fees and charges, or any third party charges, may total more than you would have paid if you had elected to pay per cycle. You recognize that this compensates Shady Grove Fertility Reproductive for the “risk” associated with not being paid if the procedure is unsuccessful or if you conceive after multiple attempts. 2. You have been given the alternative option of paying for medical services per treatment cycle. The payment option you choose is entirely up to you. The medical care and services provided to you by Shady Grove Fertility do not differ because of the payment method you select and are not dependent upon which payment method you choose. 3. By signing this agreement, you voluntarily elect to participate in the Shared Risk Program established by Shady Grove Fertility, which is described above. You should not sign this agreement until all of your questions relating to the Shared Risk Program have been answered to your satisfaction. |
Anonymous
| Thanks for the info!! |
Anonymous
| This is extremely helpful. Thanks for posting. BTW, is this posted text the full Shared Risk contract, or is it on a portion of the contract? |
Anonymous
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Also, are the "Riders" a cost above-and-beyond the cost of the Shared Risk program, or are they included in the program cost (assuming you choose the PGS option with your Shared Risk contract)?
Has anyone over the age of 40 been told that PGS is not a requirement for them? We've been told that by SGF, but this post seems to contradict that possibility. |
Anonymous
| Riders are extra costs. |
Anonymous
My understanding is that SGF dos not offer shared risk for patients older that 40. For not shared risk patients, it's your choice whether to do PGS testing. For what it's worth, our RE was not too enthusiastic about PGS testing. We had to strongly insist on it. At the end, it was the right decision for us. |
Anonymous
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I just wanted to add that I had no problem getting my $$ back from shared risk after 3 failures. We used the $$$ to go to Cornell and had twins there.
I am the only person I know of who got into shared risk and did have a successful cycle at SG so this is rare. doing shared risk made the process so much less stressful!!! Even if I had gotten pregnant the first time I would not have regretted it. |
Anonymous
| I was in shared risk and did 1 egg retrieval and 8 transfers and then withdrew and got our money back too. Saved ones $50k |
Anonymous
SG does not do shared risk for "regular IVF" for older than 40. I did shared risk at SG for DE. It took a lot of the stress away. We did not do PGS and did not plan to, so I don't remember if those riders were included with our contract. |
Anonymous
They actually do offer Shared Risk to over 40s now. I am 40 years old and 8 months and I was offered Shared Risk. My numbers are good so I met their threshold. They said I would not be kicked out at 41 but that as things progress they can discontinue at any time, but you still get your money back. I was told I could withdraw at any time as well and get my money back. They changed this recently (you can see it on their blog, it was around April). |
Anonymous
What do you think made your experience at Cornell successful (versus SG)? How many tries did the people you know have to make to be successful under shared risk at SG? |
Anonymous
Wow, we have a very similar story. We also did shared risk years ago. First transfer took but resulted in chromosomal abnormality and TFMR. We were scared then, and took our only other embryo, thawed it, tested it, found it was normal, froze it, and thawed it again. Ultimately I think the testing and freezing/thawing damaged it, so BFN. After that we had back to back miserable retrieval cycles with nothing making it to day 5. At that point we got all of our money back and went to Cornell, where Dr. Davis advised day 3 fresh transfer with co-culture. Shady Grove does work for a lot of people, but it didn't for us. And I'm glad that we invested in the shared risk. We didn't want to be in the situation where we paid so much with nothing to show for it, and we also were so thankful to be able to use that money to get our rainbow baby. |
Anonymous
Most people I met got pregnant their first or second cycle in shared risk. I think what made Cornell better for us is that Dr Davis is very gifted at adjusting your meds very precisely -- I used to have follicles of all different sizes at SG with Cornell I had a group of follicles that were all around the same size. Also I think coculture helped. At SG I always only had 1 or 2 embies available for transfer (everything else stopped growing between days 1 and 3). At Cornell I had about 8 embryos so we could pick the best two to transfer. |
Anonymous
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What is the Gestational Carrier Rider for 5K?
You pay extra if you use one? Or something else? |
Anonymous
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Thanks, OP, this is great! Any idea what numbers you need to be approved?
"They put all numbers in the computer and approve you if your success rate is above certain %." |