kaiser referral to SG

[Anonymous]

With Kaiser when you get a referral for SG, how did it work? Do you have to prove how long you have been trying or anything? Does it go through quickly? Once you go to SG, do you have to pay out of pocket and submit receipts to Kaiser or do they work with SG? Anything else I should know about using Kaiser through SG? Thank you thank you!

[Anonymous]

We received treatment at SG for infertility through Kaiser.

I had seen my OB for preconception counseling as part of my regular check up, so he knew when we started trying. Apart from that I don't know if they check if you've been refilling your birth control pills.

After a year of trying we saw my OB, who spoke to us about timing intercourse and ordered the day 3 blood tests (FSH, AMH, various other things) and the HSG which was done at a Kaiser facility. This is a good thing as they will charge you less than SG for the same tests, or at least they did for us. Once those results were in, he gave us a referral to SG. Based on that I called and made an appointment for the consultation. From there on out it was fairly straightforward. There were a couple of additional tests that the SG RE ordered, and the only confusing thing about that is that some of them I got my blood drawn at SG and some of them I had to go to Kaiser to get my blood drawn. The SG nurses will explain all of that - they are pretty familiar with how Kaiser works. Once treatment starts, all the monitoring appointments including blood draws are at SG facilities.

Two warnings:
1. My experience with the financial counselors as SG is that the information they gave me was not consistent with what was in the Kaiser evidence of coverage. Make sure to doublecheck everything they tell you with that evidence of coverage.
2. If you have a thyroid issue or other medical issue that you're being treated at Kaiser for, don't count on SG to be cognizant of that. If you have hypothyroidism, make sure to work with Kaiser to keep your TSH below 2.5 during treatment, and get your TSH tested immediately once you get a positive pregnancy test. Many doctors will immediately increase thyroid medication doses as soon as a woman learns she's pregnant because of increased thyroid demands in the first trimester. SG won't necessarily warn you to stay on top of that.

[Anonymous]

Anonymous wrote:With Kaiser when you get a referral for SG, how did it work? Do you have to prove how long you have been trying or anything? Does it go through quickly? Once you go to SG, do you have to pay out of pocket and submit receipts to Kaiser or do they work with SG? Anything else I should know about using Kaiser through SG? Thank you thank you!

I told my OB I had been trying for 6 months (I was over 35 at the time). My KP OBGYN ordered all the required tests which had to be done through KP (blood tests, HSG, saline ultrasound). Then KP put the referral through to SG. You'll be responsible for 50% of the cost (at least that's how my plan works) at each and every appointment with SG. SG will then bill KP and deal with them directly. You'll get EOB's from KP for your records. I was also required to submit a copy of my marriage license to SG prior to treatment (apparently KP required it). Good luck!