As a new patient to Overlake Reproductive Health, we highly recommend that you contact your insurance company to obtain coverage information for the diagnosis and treatment of infertility. To help you with this task we have compiled a list of questions to ask your insurance provider. This list can be used by calling the contact number on the back of your insurance card and asking the representative the questions below. Please record the results and bring those with you at your first visit. The information you collect is very helpful. We will take your answers and compare them with the information that we have acquired to make sure everyone is on the same page. Insurance companies can sometimes give out inconsistent information so this check is important. It helps us bill your insurance, and it helps you understand what your benefits are. Please remember that any information your insurance company gives you is not a guarantee of coverage or payment. We also have PDF/Word versions that are better formatted for printing.
- Are Dr. Kevin Johnson and Dr. Khurram Rehman listed as participating providers?
- Is Overlake Reproductive Health Laboratory listed as a participating lab?
- Do I need a referral from my Primary care provider to be able to see Drs. Johnson or Rehman?
- Do I have any coverage for infertility?
- Do I have coverage for testing to diagnose the cause of infertility?
- If yes, what is my co-pay for diagnostic office visits?
- Do I owe anything above and beyond my copays for diagnostic coverage?
- If no, please skip to question 10.
- Do I have coverage for the Treatment of infertility?
- Do I have coverage for sonograms related to infertility treatment?
- Do I have coverage for Artificial Insemination (IUI)?
- Do I have coverage for In Vitro Fertilization (IVF)?
- If yes, what is my co-pay?
- If yes, what is my coinsurance?
- Do I have coverage for fertility medications?
- If yes, do I need to go through a special pharmacy? Any other stipulations?
- Pharmacy: _____________________ Phone# _____________________________
- Is pre-certification required for IVF?
- What is my lifetime Maximum benefit for infertility?
- How much is remaining?
- What is my annual deductible?
- How much is remaining for the current year?
- Is preauthorization required for the following?
- Treatment procedures performed in the office?
- Oral/injectable Fertility Medications?
- OB ultrasounds performed in the office?
- Is pre-certification required for out-patient surgery?
Representative Name: ___________________________________________
Insurance Company: ___________________________________________
Phone # Called: ___________________________________________
Date Called: ___________________________________________
