Whether you are changing employers or it is time for open enrollment, Shady Grove Fertility offers the following insurance information that may be helpful to you as you consider seeking treatment at our Center. For patients who are changing or may change insurance plans, please note the following important points:
- You must advise us when your insurance information changes. We may need to place your treatment on a temporary hold if your insurance changes and we are not advised in a timely manner.
- Even if your insurance company stays the same, your employer may purchase different benefits affecting your plan. We encourage you to independently re-confirm your benefits with your employer prior to starting treatment. Please also present your insurance card to Patient Services so that we may assist you with benefit verification.
- Your new or updated insurance plan will not allow Shady Grove Fertility to verify your benefits until they are in place with your insurance company. For most plans, this does not happen until the start of the new calendar year or later. You may have proof of eligibility given to you by your employer, but until your benefits are actually loaded in your insurance plan’s system, we cannot access or obtain fertility benefits or obtain authorizations on your behalf. Timing of new treatment cycles for the early week(s) after the first of the year have proven from experience to be particularly problematic.
- Many insurance companies require pre-authorization to cover treatment. If you wish to utilize your insurance coverage, treatment can only begin after we have obtained the necessary pre-authorizations. Some health insurance plans may take up to 1 month to process treatment authorization once received.
If you plan on starting a treatment cycle, our Financial Team will assist you with benefit verification and obtaining treatment authorizations after your new patient consult has occurred. Please keep in mind that we must work through your insurance plan to obtain benefits and authorizations, and there may be delays on their part in processing insurance changes and registering new enrollees.
Please note, Shady Grove Fertility employees cannot advise patients on which insurance plan to choose.