I had this same issue in the fall. Only thing you can do is appeal. My first appeal was accepted. Currently waiting on second appeal. I never realized how terrible insurance companies are to deal with until this.

Thanks for your reply! I’m at CCRM currently and was told they’ve had so many issues with FEP Carefirst that they make clients pay upfront and then they will submit to insurance but if it gets kicked back then they keep your out-of-pocket payment without any further follow-up with Carefirst. Not really an acceptable solution IMO, especially since they’ll be charging me the full cost vs. the negotiated rate with Carefirst. So total cost for monitoring for a TI cycle would be $1,800! That’s what SGF charged for an IUI cycle all-inclusive! It’s so frustrating when your insurance company and clinic refuse to talk to each other to fix the problem.

Yeah, I think my Dr's office said they had to challenge BCBS on it, but that they ultimately paid. Can your Dr's office help?

Yeah, I think my Dr's office said they had to challenge BCBS on it, but that they ultimately paid. Can your Dr's office help?

Hi - I'm wondering if anyone else is having issues with FEP BCBS refusing to cover a timed intercourse (TI) cycle? It was previously covered no questions asked but both SGF and CCRM have told me that recently BCBS has been rejecting the code for "unexplained infertility" and refusing to cover TI cycles. I've been fighting with BCBS over this for 6+ months and no one seems to know how to fix the issue - SGF and CCRM are saying they're using the only code they have for my diagnosis and BCBS is saying they need to use a different code (but can't tell me which code to use). Beyond frustrating! Anyway, just wondering if anyone else has had this issue and, if so, whether it was resolved and how. Any thoughts on how to proceed would also be helpful. Thanks in advance!