Did you know your complication before the initial RE consult?

I called my insurance company about getting information on the centers of excellence (I have NYSHIP Empire, so we get the best coverage and rates at these COE) and she told me that before they sent that, I should have a diagnosis code so I can get pre-certified.

In my head I'm thinking - wouldn't it make sense to tell me the centers that I'll be able to go to assuming we need IVF or treatment, so I get my consult there?

I was just wondering - did any of you already have a diagnosis code before your initial RE consult? I just found it confusing - I thought at the RE, they would do all of testing anyway.

Re: Did you know your complication before the initial RE consult?

I knew I had PCOS before I saw an RE because I was diagnosed as a teenager.

I'm sorry this is so frustrating!!

Re: Did you know your complication before the initial RE consult?

I mean - does it matter though?

We know the problem - does DH have to go to another doctor before the RE?

As I'm typing this, it sounds like such a stupid question LOL

Re: Did you know your complication before the initial RE consult?

I'm actually not sure.. def doesn't sound like a stupid question to me though!

I hate how they have you jump through all these hoops! Amazing how some people can just

ETA: Amazing avatar....... between you and angel333, I'm loving the cat trend!!

Message edited 1/6/2011 10:20:52 PM.

Re: Did you know your complication before the initial RE consult?

i had to go to the RE to get d/x with PCOS. because of that my first few appointments were billed as infertility and not PCOS. my insurance at the time had no infertility coverage and i had to pay out of pocket. after three appointments i asked the office to file under the code for PCOS. all of the appointments were covered after that.

you dont HAVE to get the code beforehand, it just might help if your insurance only covers certain things. if your plan has infertility coverage you should be covered either way, although you should still find out exactly how they will bill it to be sure.

Re: Did you know your complication before the initial RE consult?

Posted by PennyCat

I'm actually not sure.. def doesn't sound like a stupid question to me though!

I hate how they have you jump through all these hoops! Amazing how some people can just

ETA: Amazing avatar....... between you and angel333, I'm loving the cat trend!!

Re: Did you know your complication before the initial RE consult?

Re: Did you know your complication before the initial RE consult?

Posted by AnnaBella816

Posted by FlowerWife

i had to go to the RE to get d/x with PCOS. because of that my first few appointments were billed as infertility and not PCOS. my insurance at the time had no infertility coverage and i had to pay out of pocket. after three appointments i asked the office to file under the code for PCOS. all of the appointments were covered after that.

you dont HAVE to get the code beforehand, it just might help if your insurance only covers certain things. if your plan has infertility coverage you should be covered either way, although you should still find out exactly how they will bill it to be sure.

We have really good coverage, so I guess I'll just hope the center we pick is a COE so that we can keep going there.

Yay! I think I'm going to call tomorrow and try and set up an appointment in the next couple weeks

THanks!

Message edited 1/6/2011 10:33:46 PM.

Re: Did you know your complication before the initial RE consult?

Posted by FlowerWife

Posted by AnnaBella816

Posted by FlowerWife

i had to go to the RE to get d/x with PCOS. because of that my first few appointments were billed as infertility and not PCOS. my insurance at the time had no infertility coverage and i had to pay out of pocket. after three appointments i asked the office to file under the code for PCOS. all of the appointments were covered after that.

you dont HAVE to get the code beforehand, it just might help if your insurance only covers certain things. if your plan has infertility coverage you should be covered either way, although you should still find out exactly how they will bill it to be sure.

We have really good coverage, so I guess I'll just hope the center we pick is a COE so that we can keep going there.

Yay! I think I'm going to call tomorrow and try and set up an appointment in the next couple weeks

THanks!

just so you know my current insurance (not the same one i started with that i mentioned above) also does the COE thing. i just saw the RE that i most preferred, regardless of that.
everything has been covered so far with no issue. so pick the RE that makes the most sense for you - not just because they are considered by your insurance carrier to be a COE.

Re: Did you know your complication before the initial RE consult?

I knew I had PCOS but was later diagnosed with a few additional issues.

Re: Did you know your complication before the initial RE consult?

We have NYSHIP and I didn't have to provide a dx code or anything when I called to get authorization. We were authorized a year ago or more so maybe it has changed.

Re: Did you know your complication before the initial RE consult?

I have NYSHIP as well. I don't know if there are different plans but I didn't have to get precertified or get a diagnosis code. I called NYSHIP before I went to find out about my coverage but my RE's office has handled all the paperwork.

Re: Did you know your complication before the initial RE consult?

I have NYSHIP as well...I am still going to my regular OBGYN who is doing my clomid cycles...but I know that this is one of the centers of excellence under the nyship plan http://www.longislandivf.com/index.shtml

I don't go there so I can't say if they are good or not, but who knows! Maybe in a few months I will be asking them for help...

Re: Did you know your complication before the initial RE consult?

i have the same insurance and i am with RSofNY (a COE). i guess i went in specifically for recurrent m/c, but i still don't know the root. i don't know anything about a code or getting pre-certified, but i get great coverage there.

Re: Did you know your complication before the initial RE consult?

no, i didnt know my dx before my re appointment....and after a bunch of re appointments they still dont know

Re: Did you know your complication before the initial RE consult?

Posted by AnnaBella816

I called my insurance company about getting information on the centers of excellence (I have NYSHIP Empire, so we get the best coverage and rates at these COE) and she told me that before they sent that, I should have a diagnosis code so I can get pre-certified.

In my head I'm thinking - wouldn't it make sense to tell me the centers that I'll be able to go to assuming we need IVF or treatment, so I get my consult there?

I was just wondering - did any of you already have a diagnosis code before your initial RE consult? I just found it confusing - I thought at the RE, they would do all of testing anyway.

Re: Did you know your complication before the initial RE consult?

NO and two years later i STILL don't !

Re: Did you know your complication before the initial RE consult?

Posted by maybemommy10

NO and two years later i STILL don't !