BCBS definition of ART

[Anonymous]

I had a couple of timed intercourse cycles last year that my insurance (BCBS FEP) interpreted as ART and didn't pay for monitoring like I thought they should. I thought that all aspects of timed intercourse were covered, but now I am wondering if my use of Follistim puts it into the ART category because it's an injectable used in IVF?

It could all be a mistake because I was doing IVF before I went back to TI for a couple of cycles, so perhaps they are misinterpreting my records. So of course I am going to appeal it, but I was just wondering if their definition has changed somewhat from what I had known in the past. The reps don't seem to be knowledgeable.

[Anonymous]

Anonymous wrote:I had a couple of timed intercourse cycles last year that my insurance (BCBS FEP) interpreted as ART and didn't pay for monitoring like I thought they should. I thought that all aspects of timed intercourse were covered, but now I am wondering if my use of Follistim puts it into the ART category because it's an injectable used in IVF?

It could all be a mistake because I was doing IVF before I went back to TI for a couple of cycles, so perhaps they are misinterpreting my records. So of course I am going to appeal it, but I was just wondering if their definition has changed somewhat from what I had known in the past. The reps don't seem to be knowledgeable.

Yeah I’m pretty sure my BCBS plan only covers timed intercourse with oral medications unfortunately.

[Anonymous]

BCBS covered my timed intercourse cycle with Gonal-F. It took forever and I had to appeal but they did eventually pay it. It’s a coding issue - there’s no good billing code specific to timed intercourse and they seem to assume it’s ART. I also only had issues when I switched back to timed intercourse after failed IVFs. Good luck!