At Fertility Specialists of Dallas, our goal is to alleviate some of that stress and help you work with your insurance company to ensure that you are reimbursed at the maximum level that you are covered. Please call Michelle, our office manager for questions or assistance.

In addition, we have a prepared a document that answers key insurance questions.
Click to download: Insurance Information for Patients



Insurance Tips

As a patient you can be the best advocate for yourself by thoroughly understanding your policy. It is important that you review your specific policy and understand what will be paid and what will not.

When pursuing insurance coverage, do not just handle it over the phone. If you simply call and ask about coverage for a certain procedure, the customer service representative may give you his or her interpretation of what he/she thinks the policy states.

You should contact your insurance company and request a written pre-determination of your exact coverage and any eligibility requirements that must be met in order to have that service covered.

It is also helpful to get any determination of benefits and coverage in writing from the insurance company. If you receive a verbal verification of coverage, you will not have any written documentation. Written verification of their intent to pay is a much more effective tool than verbal if you have a challenge.

Establishing a point of contact with a representative at the insurance company is a good idea and may enhance follow-up. All phone conversations regarding coverage should also be backed up with a written record.

Here are important questions to ask the insurance company:

• What is the specific policy or procedures that I need to follow to get infertility treatment covered? For example, do I need separate referrals or authorization for each office visit, blood work or office procedures?
• Is there a dollar maximum associated with infertility treatment? If so what is that dollar amount?
• Is there a maximum lifetime amount for Intrauterine Inseminations (IUI)?
• How many cycles of In Vitro Fertilization are covered?
• Are fertility medications covered and if so, am I required to use a particular pharmacy?

• Referral
  a form issued by a primary care physician or ob/gyn referring a patient to a specialist. If applicable, all referrals are obtained by the patient
• Authorization
  a number issued by an insurance company authorizing a specific service or medication. The doctor or the patient, depending on the insurance, can obtain authorizations.
• Pre-certification
  a number issued by insurance for a surgery or in office procedure.
• Pre-determination letter
  a letter from an insurance quoting benefit coverage according to the specific patient policy.