If infertility is included in your policy coverage, please ask the following questions:
- Is my policy for diagnostic service only?
- Do I have coverage for the underlying conditions?
- Would CPT codes 58322 & 58323 with diagnosis code V26.1 be covered?
- Would advanced Reproductive Technology – using CPT codes 58970, 58974, 58976, 89258, 89280 and the diagnosis code 628.9 be covered?
- Is there a pre- existing clause on my policy in reference to infertility treatment or surgery procedures?
- Do I have any drug coverage for infertility treatment? If yes, where? {mail order or local pharmacy} What drugs? { i.e Bravelle, Follistim, Gonal F, Lupron, Menopur}
- Do I need a referral and/or prior authorization for any office visits or procedures? {If yes, please secure this prior to your visit- failure to follow the guidelines of your policy may result in denial of covered services}
- Have I met my deductible?
- What is my co-pay or co-insurance that will be due?
We are Reproductive Specialists. If you have a specialist co-pay/co-insurance or if the deductible has not been met on your policy, please be prepared to pay this amount for covered expenses.
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