Insurance Reimbursement Rates at CCRM?
Hi all! I have a lifetime max that I am trying to keep track of. I currently go to SG in DC but I am considering the switch to CCRM NOVA. I have BCBS for medical, it’s Horizon, but may go through locally as CareFirst ($25k lifetime max) and SG rates that my insurance actually pays is relatively reasonable. Maybe ~ $4k per egg retrieval (includes appts/labs/surgery/ no meds though). This is only for retrieval. The finance person at CCRM NOVA started to really freak me out and act like their billing is so much different and much pricier than SG. I asked what the typical reimbursement rate was as that’s what comes out of my lifetime max and she said she couldn’t give specifics but they charge a bundle price and that it’s round $20k and reimbursement from insurance for one retrieval is around $10-12k - when she saw claims last year. This is not including other fees they don’t bill insurance like surgical site fee/anesthesia/testing/freezing etc.she said she couldn’t give me ANY idea or specifics.
I was shocked that it could be double or more the cost of the same retrieval at SG. I have DOR and I’m 34 so I feel like it may take me many cycles to get there so I’m hesitant to switch clinics if I can’t do as many rounds at the new clinic.
Does anyone remember what they saw as reimbursement rates were for their egg retrievals from ccrm? Perhaps it was also a bundled fee? I’m trying to get a rough idea as I would find it hard to believe the same plan would plan so much more just for a different clinic doing the same things. I understand a slight variation but that seems like a lot.
Bonus points if you are a BCBS medical person and/or go to CCrM NOVA. I don’t want to be scared away from someone in the finance dept that may not know a lot or be fully understanding when really I feel like their clinic is the next best step for me in my journey.
Thank you all!!!!!
my $25k lifetime max is only for medical procedures/not for drugs*