Finances -- General Information
Also see IVF Finances

We truly are aware of the high cost of medical care and will do our best to limit costs and maximize efficiency in diagnosis and therapy, but we will not compromise quality care. We believe that we enter into a contract with our patients to provide the highest standard of care. We work diligently to explain the, why, and how of therapy, chances of its success and alternatives. We ask that our patients honor this relationship by prompt payment of accounts. We will do our best to help you navigate through the maze of insurance and managed care, but the final responsibility for your account remains with you.

Most reproductive medicine practices will not accept, or will not directly bill insurance plans. We do both. We participate in a large number of insurance and managed care plans and actively seek other plans to join. We will directly bill your insurance company for covered expenses. Some services may not be covered and you must be aware of the specific limitations of your plan.

Our charges are determined by the complexity of the problem under evaluation, procedures/tests performed and time spent. We will not exceed the standard fees charged for comparable specialist services. In some cases these may be higher than fees for a gynecologist or primary care physician, in other cases less. A complete fee schedule is available on request. We invite open and advance discussion about our fees. We strongly believe that money alone should not prevent therapy.

Financial planning for medical service is a fact of life. The language of insurance policies is complicated and easily misinterpreted. We try to help make this as easy and effective as possible. Please let us review your plan with you before your first visit and before any major financial decisions are made. Open and constant communication will solve many problems and misunderstandings can be avoided, or resolved.

You may contact our insurance and billing department at 423-461-8898 with specific financial questions. PLEASE call.

REFERRALS, while recommended, are not necessary for appointments. However, a referral from your gynecologist or primary care physician (PCP) may be required if you have a health maintenance organization (HMO). In these cases, if you are seen in our office without a referral, your insurance company will not cover your visit. It is your responsibility to obtain this referral prior to being seen. If you have a "Point of Service" plan and you did not obtain a referral, then your "in-network" benefits may be in effect, but your "out of pocket" expenses will be greater.

VERIFICATION OF COVERAGE is necessary prior to any insurance billing being done. If we do not have a current copy of your insurance card, you will be responsible for payment. If during the course of your treatment your insurance changes, we will need the updated insurance information. If we are not contracted with your plan, you will be expected to pay for your treatment at the time of service.

CO-PAYMENTS, DEDUCTIBLES AND NON-COVERED SERVICES are due at time of service even if our office has contracted with your insurance plan.

PAYMENT AT TIME OF SERVICE is expected. We will bill your insurance only if we have contracted with your health plan and only for the services that are a covered benefit by your insurance company. If payment is not possible we will work with you, but you have to let us know in advance.

PRE-AUTHORIZATION is necessary for many services. We will work with you, but be aware of the limitations of your insurance plan. Insurance information will need to be verified before any procedure. Typically pre-authorizations take 7-10 working days. If this is not obtained, you will be responsible for payment of your treatment. Time is of the essence; we are depending on you to help keep us informed.

SURGERY CHARGES, fees, co-pays ad/or deductibles can be discussed prior to surgery if desired. You will also be receiving separate billing from the hospital, anesthesiologist and pathologist.

CHANGE TO YOUR INFORMATION it is critical that you notify us as soon as possible of any changes to your address, telephone numbers, employment, insurance, and/or name changes so that we may keep your records current.

PAST DUE ACCOUNTS are a situation we hope will never arise. If it is a question of quality of service, we must know to correct the problem. Computers and people make mistakes. We will correct any error on our part immediately. Past due accounts can jeopardize your continued service and your credit rating. We really want to keep you as a patient and almost any problem can be worked out if you will continue to talk with us. Past due accounts are subject to legal action and/or collection agencies. If your account is sent to collections, you will be billed the balance of your account plus charges due to the collecting agency.

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