I also am a biller for a Fertility Practice. I have services that are non-covered. Obviously, we can't bill insurance for our entire package of InVitro or Insemination when they don't pay for Infertility Treatment. However, there are somethings that they consider non-covered, like for some insurances Semen Analysis or the HSG is "non-covered", which is ridiculous because insurances pay for diagnostics and treating underlying causes and these two are diagnostic. (On a side note, that's where we Fertility Clinic billers need to send letters to our State Insurance Commissioner and show them how insurance companies aren't abiding by their contractual agreements) However, I bill them and have had BCBS tell me you can't bill the patient but other insurances tell me it's at our discretion but they encourage us to take the contracted rate only. I will usually do that for the patient. Something like our OR fee...I have the patient sign a Non-Covered Services agreement so they understand up front that it is possible the insurance company won't pay the fee and they will be responsible for it. Then I only charge them what is costs us to have them in our OR... staff costs, meds, supplies etc.
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