IVF doctor charge

Hoping to get advice from other poor souls who have gone through similar issues, which my insurance (UHC Oxford) has been taking me in circles for the past 3 months-thanks for any help!

My policy has a lifetime max of 3 IVF retrievals and 3 IVF transfers. I have had the following procedures (in chronological order): 1. Retrieval #1 and 1 fresh transfer 2. frozen transfer 3. Retrieval #2 4. frozen transfer 5. Retrieval #3 and 1 fresh transfer

For (3)- I am getting billed a hospital fee and a fee from my doctor. The hospital fee is covered but the doctor fee is denied. The reason provided is “The maximum benefit under the plan has been met. The member is responsible for the amount due”. Should I appeal this because it is for the 2nd retrieval, which should be covered?

For (5)- I am having the same issue with the hospital fee is covered, but the doctor fee is denied. The reason provided is “Benefits for this service are denied. Your plan does not cover infertility, or certain infertility services.” Should I appeal this for the same reason above?

Also for (5)-the doctor billed the retrieval and the fresh transfer in 1 invoice (they bill as 1 IVF cycle). Should I ask the doctor to split up the invoice so I can get my insurance to cover the retrieval portion only?

submitted by /u/athk12
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