Financial

Fertility treatments are often complex and labor intensive. They can also be quite expensive. We urge you to investigate your insurance coverage before embarking on this journey.

Please make sure that you are familiar with the specific requirements of your plan such as referrals and filing requirements. Be sure to understand the laws governing coverage of fertility treatments in your state and whether they apply to you. Below is a summary of the Connecticut law governing coverage of infertility diagnosis and therapy. Despite the fact that CT is a progressive state, it still does not provide coverage to women who are over the age of 40!!! Similarly, companies that are self insured and certain religious organizations are exempt.

Our financial department will assist you in determining insurance coverage, the need for pre-authorization and the cost to you for any part of the treatment.

We realize that the financial burden adds to the stress of infertility and will do our best to help you sort out your options.

NEFI Financial Policy

NEFI is sensitive to the high cost of fertility treatments. We have designed our services to keep the cost down, the prices competitive and to help you maximize your insurance benefits.

Payment is due at the time services are rendered unless prior arrangements have been made by the NEFI billing department. Payment may be in Cash, check, or credit card. If we have a contractual agreement with your insurance company, we will bill the carrier directly. If we do not have a contract with your carrier, but you can obtain written verification of coverage for the specific test or procedure, we will be your carrier directly on your behalf. If you do not have coverage or if you prefer to submit your own claims, your account will be designated as "self-pay"; we will not bill your insurance company and you will be responsible for all the fees. In some cases as noted below "self-pay" patients may be asked to pre-pay for certain procedures such as IVF and egg donor.

Your insurance coverage is a contract between you and your insurance carrier. It is therefore your responsibility to contact the insurance carrier regarding unpaid claims. THE RESPONSIBLE PARTY HAS THE OBLIGATION TO PAY ALL THE FEES NOT PAID BY THE INSURANCE COMPANY.

NEFI is a provider of medical services and therefore our relationship is with you, our patient, and not with your insurance company. As a courtesy we do file your claims with your insurance company. However, all charges are ultimately your responsibility.

All fees incurred are due at time of service. We accept credit cards and will provide you with a bill that can be submitted to your insurance company. Depending on your insurance plan, a co-payment may be required at the time of your visit.

1. Initial Consultation: After you call for your appointment, our financial staff will call your insurance company to help you understand your benefits.

   Following your consult, our financial consultant will meet with you, explain your insurance coverage, and the anticipated cost of treatment.

2. Payment is due:

   • IVF: Prior to starting the treatment cycle.
   • Egg Donation cycle: at the time of match with a donor.

Insurance

We urge you to check with your insurance company as to the coverage provided by your policy.

Many insurance companies provide online access to your benefits or call centers to assist you.

Questions to ask you insurance company's representative

1. Is there a specific person who handles questions regarding infertility converage? Request to see the insurance manual regarding infertilty coverage.

2. Is there a pre-existing condition limitation?

3. What percentage of medical expenses is covered?

4. Is there a co-payment for services or for medications?

5. What is the annual deductible?

6. Is there a maximum out of pocket expense you can incur in a single year?

7. Is there need for pre-authrization of services?

8. What procedures should be followed when filing a claim?

9. Is there a specific pharmacy that should be used to order the mecdicaions?

10. Is there a time limit you can be treated for infertilty?

• NOTE: In many cases, even though the treatment may be covered, pre-authorization may be required.

• Some insurers have a lifetime maximum for infertility treatment.
• Please note the pre-authorization may not guarantee payment. Claims may be denied or partially covered following the procedure. Patients covered under such policies will be responsible for the payment of the balance.
• CT Mandate: A bill mandates insurers to cover infertility Rx and treatment as of October of 2005. If you are under the age of 40, you qualify and will have your treatment covered. Check with our finance department for more information.
  • CT Mandate explained

IVF Shared Risk Program

The concept of shared risk IVF was developed in order to make the IVF procedure more affordable to patients who do not have medical insurance to cover this complicated but very effective procedure.