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Fertility Treatment Costs - Financial Information
Insurance coverage for
infertility services varies
greatly. Most health plans reimburse diagnostic
services that enable the physician to determine the cause
of your infertility but few plans reimburse treatment
procedures such as intrauterine
insemination (IUI) or in
vitro fertilization (IVF). 
Financial Counselor
Lois Solomon is the
Premier Fertility Clinic, Greensboro, NC Financial Counselor. She
will meet/talk with you, discuss your current insurance
coverage, and determine if a payment is necessary for
the procedure(s) you will be having. Prior
to your first appointment you will need to contact your
health insurance carrier and determine if infertility
benefits (diagnosis and treatment) are available to you.
Financial Policies
We would like to make you aware of our
current financial policies regarding services performed
at the Center. The Center participates with most
health insurance plans. Please check with us to
confirm we participate with your's.
Covered Fertility Treatments
If the Center participates with your current
insurance carrier(s) and the service performed is a covered
benefit, we will accept the amount your carrier deems
reasonable or allowable. If our charge is greater
than the allowable amount determined by your insurance,
as participating providers we will reduce our charge to
the allowable amount. Your responsibility may be
a co-payment (a fixed dollar amount per visit) or coinsurance
(a percentage of the allowable amount). The Center
requires all co-payments be made at the time of service.
Otherwise you will be billed for coinsurance amounts.
Non Covered Services
If the Center determines any service
is not covered by your insurance carrier you will be required
to pay for those services when rendered. The Center
also offers self-pay packages for
IUI and IVF
cycles that are not covered by insurance. The
package amount includes all monitoring
services and the treatment procedure. You will be
billed for a single total amount instead of each service
separately. The package amount
will be calculated by Lois, will be due prior to the beginning
of your treatment cycle and will be posted to our computer
system when received. Non covered charges
will not be submitted to your insurance. We will
provide you with a receipt for the package amount.
Any outstanding balances must be paid
in full prior to beginning treatment. Balances from
prior treatment cycles must also be paid in full prior
to beginning a new treatment cycle.
Payment Types
The Center accepts checks, cash, debit
cards, Visa, Master Card, or Discover.
Initial Visit
Some patients are enrolled in HMO’s
(health maintenance organization) or POS (point of service)
health insurance plans. If this applies to you,
it is your responsibility to obtain the appropriate referral(s)
for your initial visit from your primary care doctor.
You will meet with Lois during your initial visit and
review your current insurance coverage with her.
After your initial appointment, Lois will investigate
which future services need referral or pre-authorization.
Billing of Services
Infertility
is a disease process that involves two individuals which
complicates the billing of services rendered. The
majority of infertility charges will be billed to the
female. The male will be billed for all sperm related
charges. It is important for you to review your
health insurance coverage(s) since both of you will be
billed for infertility services. The Center has
created patient fee sheets that detail the costs of services
and who those costs will be charged to. Lois can
provide these to you.
Other Infertility
Financial Considerations
Flexible Spending Benefits
Some employers allow employees
to set aside a specified amount of your salary on a pretax
basis for unreimbursed medical expenses. This allows
you to pay your medical bills with pretax versus post-tax
dollars. Check with your employer and determine
if flexible spending benefits are offered to you or your
spouse.
Income Tax Deduction
If your out-of pocket medical expense
is high you may be able to deduct a portion of your medical
bills on your income tax return. To do this you
must be able to itemize deductions on your tax return
and your medical expenses must exceed 7.5% of your adjusted
gross income (AGI). Consult your tax advisor for
details.
Home Equity Line of Credit –
HELOC
Refers to a loan in which the lender agrees
to lend a maximum amount within an agreed period.
HELOC loans have become very popular in the United States
in recent years, in part because interest paid is typically
(depending on specific circumstances) deductible under
federal and many state income tax laws. This effectively
reduces the cost of borrowing funds. Consult your
banker and tax advisor for details.
Alternative Forms of Payment
Other payment options you may want to consider
include using a credit card for medical payments.
Some credit cards offer perks such as airline mileage,
a percentage back of total charges or percentage discounts
on automobiles or other services. Remember, however,
you may not wish to pay with a credit card unless you
can pay the balance in full before you incur finance charges.
Questions
If you have any questions regarding any
of the above information please contact Lois Solomon at
336-841-7070. Thank you.
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