My CCRM IVF Journey

Our successful journey through IVF #2 at one of the world's top fertility clinics

Another Insurance Headache

Posted by auntiem10 on April 26, 2010

I promise to stop complaining about being nickel-and-dimed by CCRM, but I do want to add this post for folks who may not have traveled yet to Colorado for their One Day Work-Up (ODWU). I don’t want my recent negativity to set the tone for this blog (I’m usually much more positive!), but I do want to help others prepare for the costs involved.

We received a bill last week from the Fertility Laboratories of Colorado (FLC) for the genetic counseling session we attended at the ODWU. The bill was for $150, and we could see that it had not been submitted to my insurance. FLC is in-network, so we immediately called and verified that the procedure code was eligible for coverage.

This morning I called CCRM’s business office and found out that the genetic counselors are independent contractors, and they do NOT accept ANY insurance. This is despite the fact that the bill appears to actually originate from FLC. Therefore, we are expected to pay for this 20-minute counseling session.

Our genetic counseling session was the second-to-last appointment of the ODWU. By this point, we had already waived all ancestry-based genetic testing (like Fragile X). We had also already met with Dr. Surrey, who does not recommend chromosome testing for this cycle. Therefore, we only attended this genetic counseling session because we did not know we had a choice. If we had known, we would have waived the appointment, had our blood drawn, and left the building.

Our options:
#1) Pay the $150 fee and forget about it.
#2) Talk to Surrey at the regroup about waiving the fee. If I try to establish contact with him before then, I will be charged for the appointment.

I am really upset by the way CCRM handles the ODWU. Some claims are submitted by CCRM, some claims are submitted by FLC. Some labwork was sent out to another laboratory that may or may not accept our insurance. Now we are expected to pay $150 for a genetic counseling session that we did not want to attend in the first place. I think they should review all of this information with the potential patient BEFORE the patient travels to CCRM. The money involved in the ODWU is small potatoes compared to the cost of an actual IVF cycle there, but every penny counts when trying to save that amount of money.

I’m struggling to adjust to being a tiny fish in a big pond! Someone tell me it gets easier!

To anyone planning to attend the ODWU: If you are not interested in genetic testing, ask to WAIVE the genetic counseling session. Just tell them you are not interested in attending. They do not take ANY insurance, so you will be expected to pay $150 if you attend.

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7 Responses to “Another Insurance Headache”

  1. sue said

    oh no! i had no idea that they charged for that or that they were ‘consultants’. ccrm should really relay that information to ALL patients before throwing them into the ODWU. trust me, they won’t let a penny fall thru the cracks. but the next fees will be lump payments but they are doozies! (one check for ~6000, another check for ~13,500 and one more for ~450)…its not chump change or easy, and i asked for an itemized breakdown and they said they will give me one AFTER transfer which for me will be prolly in july/august…you would think they would atleast give me an itemized breakdown now since i already paid for everything. ugh, frustrating i know…but don’t let it stress you out too much…we just have to be our own advocates.

  2. auntiem10 said

    You are so right; we must be our own advocates. Ugh, all of these bills has been a shock to my system. We were OOP for our first IVF cycle and basically just paid everything all at one time, so the new system by CCRM is stressing me out! I hated to complain two posts in a row, but I want others to be aware of this genetic counseling racket!

  3. Rambler said

    Girl, I know the feeling! Trust me.

    We didn’t have genetic counseling on our ODW spreadsheet, so I wonder if that’s why they never pushed us into the appointment.

    That’s interesting that FLC is in network for you guys! I didn’t think they were in any network. We had to pay almost $1500 up front to FLC the day of the workshop and then I got forms in the mail afterwards that sent into my insurance.

    • auntiem10 said

      Apparently the only insurance FLC takes is United Healthcare. My husband has BC/BS, so we had to pay OOP for all of his testing. We had to pay 15% OOP for my testing as well, plus the cost of our communicables, so we paid $1300 up-front. We sent forms to BC/BS, but since FLC is out-of-network, we don’t get any money back.

      How interesting that you did not have genetic counseling on your ODWU spreadsheet! I was told Monday that this appointment is actually optional, but we were never told that and were never asked whether we wanted to attend the session. What a racket!

  4. Melissia said

    I am sure that if you speak with the business manager or your case manager and explain that you were not informed that this appointment was optional and that you had already refused and decided against all genetic testing and that you would have chosen not to meet with this person had you been aware that this was optional, she will waive the fee if you ask her too.
    In the long run she will not want to lose your business if she feels that this is at risk. Good luck.

    • auntiem10 said

      Thanks for your comment! Actually, I was told by the business office that the only person with the authority to waive the genetic counseling fee is Dr. Surrey himself. I can’t talk to him about it until the regroup without the risk of being charged. It appears to me that the business office has very little authority to waive fees or make decisions. They also haven’t been particularly nice to me, and I don’t get the impression that they are too concerned with losing my business! This is just my opnion, though!

  5. […] Billing Situation #1: Remember this post? We had received a $150 bill in the mail from FLC a few weeks ago for the genetic counseling […]

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