Understanding Insurance

Understanding Infertility
Insurance Coverage

Insurance Can Be Complicated And Confusing

At IRMS, we recognize that working with insurance plans can be complicated and confusing. In most business transactions, there are only two parties—the buyer and the seller.  However, in health care, there is the buyer (the patient), the seller (the provider/doctor), and the payor (the insurance company).  This makes the process more complex because in order for the buyer to receive maximum benefit and the seller to receive payment, the payor’s rules must be followed.  Unfortunately, every payor has different rules and guidelines and individual payor’s have multiple plans—each with different requirements and coverage levels.

Fertility Financial Counseling

Our experienced Financial Counselors work with you to maximize your insurance benefit but we also require your assistance in obtaining as much information as possible about your plan. When it comes to health insurance understanding your own policy and being your own advocate are essential.

In this process, it is IRMS’ mission to be ethical in its dealings with both our patients and insurers.  Therefore, we have established the following protocol for determining benefits and payment requirements for our patients.

  • As soon as we are notified of a patient’s intent to receive services, we will contact the patient’s insurer(s) to obtain a benefit quote.
  • Based on that benefit quote, we will determine the patient’s financial responsibility. All co-payments and deductibles are due in full on the date of service.
  • We will bill insurers for all covered services provided.
  • Our objective is for you to obtain every penny of benefit to which you are entitled, but we have a contractual obligation with the insurers to not accept incorrect benefit payments.