YES, Repromedix Accepts Insurance!

Repromedix accepts assignment of benefits from insurance companies. That may surprise you, since virtually no other reproductive esoteric lab is equipped to handle insurance. In fact, when you order a test through Repromedix for your insured patients we provide several important services:

• We bill the patient's carrier directly (we do not ask for any prepayment prior to performing and reporting critical test results)
• We work with patients to help them resolve coverage issues
• We bill patients directly for deductibles, copays or any other financial responsibility the insurer informs us of (we simplify the payment process both for your patients and for your busy staff)

Every day, we do business with many of the nation's leading health insurance providers, including Blue Cross/Blue Shield, Aetna, CIGNA, United Healthcare, among others.

We'll be the first to say, however, that insurance coverage for esoteric tests is anything but simple to understand. In fact, it's pretty complicated, due to the number of healthcare insurance payers offering multiple products with different contracts, coverages, and deductibles. And each of them pays different amounts. But we think your patients won't mind navigating the process if it means less money out of their pockets.

How Clinicians Work with Repromedix

• Prepare and submit sample(s) in accordance with Repromedix guidelines
• When the sample and Test Requisition form are received, the Lab logs in all of the information
• Test results are sent to you, with a complete explanation and any pertinent follow-up recommendations
• After the test is run (within a week) our Billing department enters all pertinent information into its system
• Our Billing department bills the appropriate insurance company
• Our Billing department works with the insurance company and your patient to resolve any issues in coverage, deductibles and copays

How Clinicians Can Improve the Process

We understand how busy you and your office staff are, but a few minutes of your time can make a big difference to your patients regarding insurance coverage:

• When selecting a diagnosis code, consider your patient's potentially broader health problem. Certain diagnosis codes are more likely to trigger a denial than others.
• Make sure a copy of the patient's current insurance card accompanies the test requisition
• Encourage your patient to fully understand his/her insurance benefits prior to testing
• Advise your patient that he/she may need to work with Repromedix to advocate for coverage if a denial is issued
• No one likes surprises when it comes to payment. Advise your patient that there is a small, but real, chance he or she will receive a balance bill from Repromedix some time after the test results are already in.

Tests vs. Treatments

Why is infertility testing generally covered by insurance but infertility treatment generally isn't, and what are the differences in coverage?

Treatment

• In 13 states, insurance companies are required by law to offer some coverage of infertility treatment (mandated coverage).
• In the remaining states there is no mandated coverage for infertility treatment, and specific infertility coverage may not always be available to the policy subscriber.

Diagnostic Tests

• Hundreds of insurance companies throughout the United States regularly cover infertility testing, even if they do not cover infertility treatment.
• One key reason is that many causes of infertility are basic health problems, often with serious and diverse health consequences that go beyond infertility.
• Despite a greater willingness to cover tests, patients with limited fertility coverage on their policies may initially be denied reimbursement for these tests. Repromedix works diligently with your patients to advocate on their behalf; in our experience, aggressive attention to insurance claims often results in denials being overturned.
• Click here for a list of insurance companies, by state, with whom Repromedix has recently worked successfully

You CAN Go Out of Network

• Many physicians are under the incorrect impression that they cannot order a test from an out-of-network laboratory
• In fact, hundreds of physicians regularly go outside their network to order tests through Repromedix
• If your Exclusive Laboratory does not offer the "equivalent test" to ours, or does not offer the test at all, you can order the test from Repromedix
• You can generally also go outside your Preferred or Participating Laboratory to order tests from Repromedix without any sanctions
• As a Nonparticipating Laboratory, Repromedix participates as a willing provider to hundreds of HMO, PPO, Indemnity, and Blue Cross/Blue Shield health plans