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[quote=Anonymous][quote=Anonymous]I’m a Shady Grove IVF patient. My insurance covers 3 IVF attempts per live birth. I’ve used these up (a freeze all cycle counted as one, then 2 failed FETs). So my next FET will be out of pocket. Does anyone know if I will have to pay the $4600 cash fee, or if I would still get the benefit of the negotiated rate that they would normally receive from my insurance company?

I’ve asked my financial counselor and I don’t even think she understands what I’m asking. She says she can’t tell me anything until she runs it through my insurance and I need to decide on my FSA before then. Working with the financial people has been the most challenging thing for me![/quote]

Most of the time the negotiated rate is typically higher than the self pay/private pay price. the Clinics usually bill a substantial higher amount and the health plan (insurances) negotiate a rate between the clinics. They essentially have contracts and as such may not be able to balance bill the pt for any balances (hence the negotiated rates). To really know what the insurance paid you would have to request a claim copy from the clinic ( if they are willing to provide) or the health plan. Also note that most people have a deductible or copay. If you have met your deductible & maximum out of packet expense ( averages 3K depending on health plan) for the year then subsequent services are covered at 100% depending on your health plans. I literally had my IVF paid for at 100% since I did it close to end of year and I had multiple clomid/IUI cycles during first half of year so I was able to meet my maximum out of pocket expense for the year.[/quote]

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