Prepaid IVF services vs. lower insurance reimbursement rate

[snowrose]

Hi all,

My IVF clinic asked me to prepay for all the IVF services that were to provided. My insurance company is Aetna POS II, which covers infertility treatment including IVF. Finally I received a member reimbursement from Aetna today; however, their reimbursement rate is much lower than what I was charged. Did anyone have experience to handle this successfully? Thanks a bunch.

[mommyoneday]

The problem is with contracted versus non-contracted providers. Your clinic clearly doesn't contract with insurance and is just giving you a "superbill" to ask for reimbursement. Your insurance company doesn't pay the full amount the clinic charges. They are paying you back based on how much they are deciding the clinic should have charged you. You can try and fight and say that your clinic is charging a normal amount.... Or you may have an infertility max so that's why they aren't reimbursing back as much.