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Infertility Support and Discussion
Reply to "IVF with UnitedHealthcare MDIPA & referals with MDIPA in general"
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[quote=Anonymous]I finished an IVF cycle with SG earlier this year. You don't have to wait 2 years if you have a tubal factor but you do have to be married. Here's a summary of what is required in terms of referrals and pre-authorizaiton 1. For a Consultation a pre-authorization has to be submitted by your PCP or ob. I was authorized for 1 consultation visit. (cost-$130) 2. After the consult, SG will send in the pre-authorization paper work for your day 3 blood work, baseline sonogram, and any other testing you need (HSG, etc.) 3. HOWEVER, and this is where I got frustrated, in addition to a pre-authorization, a referral from your PCP has to be on file at SG. Some PCP's will manage this in advance when they get the pre-authroization letter from SG. My PCP's office did not since it was not very familiar with sending patients to SG. Once your PCP submits the first referral, SG will take over and submit subsequent referrals. 4. If you don't have both an authorization and referral on file, SG will charge you the cash price and then refund your money once the insurance authorization is accepted or referral with the date of your appointment is on file (~$695). However, the alternative of waiting another month is not appealing either so I ended up doing my Day 3 blood work on Day 4 since my referral was not in place on day 3 and my PCP couldn't fax it to SG the morning of Day 3. I didn't want to wait another month and I didn't want to pay $695 and hope that I get my money back (SG will have you sign a waiver). 5. MD IPA requires a pre-authorization for each procedure. SSG will submit the pre-authorizations for IUI or IVF once your treatment plan is estblished with yoru RE.[/quote]
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