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[quote=Anonymous]I'm having a billing issue, and I'm wondering if others have advice.  I switched insurance this year to get coverage for infertility treatments.  I have coverage for both IUI and IVF under my new insurance, and this is likely our last IUI cycle before making the switch.  Because of timing, we did the IUI early in the year.  My insurance (MDIPA) requires pre-authorization.  Prior to my treatment, the insurance company asked for additional information which I was told was sent prior to my procedure.  Because the coverage was still pending at the time of my procedure, I was told to wait because coverage could be applied retroactively.

Now, almost two weeks later, I called the insurance company only to find out that they never received the requested information and so were waiting to finish processing my pre-auth.  Apparently, there was an error in their fax number (I was able to determine this in less than 10 minutes on the phone).  Apparently, my clinic's billing office never bothered to check if the information was received and has instead simply been repeatedly faxing it with no reply.

I'm scheduled for my 2 week blood test tomorrow, and billing is telling me that even though pre-authorization is still pending (at least partially through the clinic's error in my view) I will have to pay the full charge before getting anymore treatment...but they will reimburse me if insurance eventually provides coverage.  While the amount is not the issue, I am very hesitant to do so.  I also find it appalling that any doctor's office would treat a patient like this.  I'm tempted to either go for my blood test and refuse to pay and leave if they insist, or skip it altogether (the wait is agony, but I'll probably know by Monday if the treatment was successful regardless).  I also think I may contact my RE directly to let them know what's going on.  This is minor compared to getting IVF approval.

Am I over-reacting?  I'm fairly familiar with medical billing in other specialities, and I don't think I know of any other doctor's practice that would insist on payment under these circumstances.[/quote]

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