Multiple consults booked- question about C.ornell

Multiple consults booked- question about C.ornell

Mrs. McIrish
Mrs. McIrish

December 6th, 2011, 11:39 pm #1

I have consults booked with C.heck and C.ornell (I'm following in Erin's footprints) as I got booted from Brigham in Boston last week following IVF#2. My question: I booked the consult at C.ornell with Dr. S.pandor.fer because he was "in network" where D.avis is "out of network" and would cost a lot more. How important is it that I see D.avis versus Dr. S? I know C.ornell bills procedures through the center but is the consult the only thing billed to the RE? I'm interested in co-culture and did AH for both IVF.

I hate to pay $500 for a consult if I can pay a $25 copay for Dr. S. unless there is a big difference.

With my insurance I have to prepay everything and then submit the bills for a 80% reimbursement but the 80% is only a reimbursement of a "reasonable and customary" charge for the service. So, if C.ornell bills $2K for something, my insurance could decide that the "going rate" should only be $1500, I'd get 80% of $1500 back. That could add up to be a disaster with a $20K charge that my insurance co decides should really be $13K, leaving me with a $10K bill. That's why I'm consulting with Check too. If anyone has actual charges from C.ornell, that would really help. The billing dept ignored my calls..

FYI: I am 38, FSH was 17.3 at last test (E2=82), AMH 0.3, only got 2 eggs on both IVF's with max stims (EPP and MDLP). Very fragmented embies on first try and embies that didn't grow on 2nd IVF (1 and 2 cell on 2dt).
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Erin
Erin

December 7th, 2011, 12:25 am #2

A couple of things:
1.) Although D.avis my doctor, Span.dorfer is doing my co-culture biopsy. They use who ever is assigned to do it for that week and rotate, although I got the sense D.avis doesn't do it too much? Could be wrong about that. I have the same insurance issue as you do, so I asked about this- it sounded like they could work with me to get someone who is covered to do the biopsy.

2.) So far I've found their billing dept to be a wicked pain in the arse! (I figure you're from the Boston area too (RI is close enough:)), so you should understand the "wicked"!) Are you trying to reach D.avis's or Span.dorfer's billers or both? In either case, my suggestion is to keep calling until you reach someone instead of leaving voicemail. It's terrible, but necessary.

3) I was told the only thing charged under D.avis himself is the consult. I don't have real experience yet, so hopefully I won't be unpleasantly surprised... I will try to be proactive though, so maybe that will help.

That's all I've got... I'm sure others with more experience could be much more helpful. Just wanted to tell you what I know. Good luck!

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BabyDance
BabyDance

December 7th, 2011, 12:32 am #3

I have consults booked with C.heck and C.ornell (I'm following in Erin's footprints) as I got booted from Brigham in Boston last week following IVF#2. My question: I booked the consult at C.ornell with Dr. S.pandor.fer because he was "in network" where D.avis is "out of network" and would cost a lot more. How important is it that I see D.avis versus Dr. S? I know C.ornell bills procedures through the center but is the consult the only thing billed to the RE? I'm interested in co-culture and did AH for both IVF.

I hate to pay $500 for a consult if I can pay a $25 copay for Dr. S. unless there is a big difference.

With my insurance I have to prepay everything and then submit the bills for a 80% reimbursement but the 80% is only a reimbursement of a "reasonable and customary" charge for the service. So, if C.ornell bills $2K for something, my insurance could decide that the "going rate" should only be $1500, I'd get 80% of $1500 back. That could add up to be a disaster with a $20K charge that my insurance co decides should really be $13K, leaving me with a $10K bill. That's why I'm consulting with Check too. If anyone has actual charges from C.ornell, that would really help. The billing dept ignored my calls..

FYI: I am 38, FSH was 17.3 at last test (E2=82), AMH 0.3, only got 2 eggs on both IVF's with max stims (EPP and MDLP). Very fragmented embies on first try and embies that didn't grow on 2nd IVF (1 and 2 cell on 2dt).
Mrs. McIrish - did you get my email? nt.
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Mrs. McIrish
Mrs. McIrish

December 7th, 2011, 12:38 am #4

I'm not seeing anything in my in box? When did you send it? cve73 at yahoo dot com?
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Mrs. McIrish
Mrs. McIrish

December 7th, 2011, 12:40 am #5

A couple of things:
1.) Although D.avis my doctor, Span.dorfer is doing my co-culture biopsy. They use who ever is assigned to do it for that week and rotate, although I got the sense D.avis doesn't do it too much? Could be wrong about that. I have the same insurance issue as you do, so I asked about this- it sounded like they could work with me to get someone who is covered to do the biopsy.

2.) So far I've found their billing dept to be a wicked pain in the arse! (I figure you're from the Boston area too (RI is close enough:)), so you should understand the "wicked"!) Are you trying to reach D.avis's or Span.dorfer's billers or both? In either case, my suggestion is to keep calling until you reach someone instead of leaving voicemail. It's terrible, but necessary.

3) I was told the only thing charged under D.avis himself is the consult. I don't have real experience yet, so hopefully I won't be unpleasantly surprised... I will try to be proactive though, so maybe that will help.

That's all I've got... I'm sure others with more experience could be much more helpful. Just wanted to tell you what I know. Good luck!
I'm never tired of hearing from you! I feel like I am stalking you, LOL!! I just can't decide if I NEED to see D.avis versus another doc there.
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BabyDance
BabyDance

December 7th, 2011, 12:42 am #6

I'm not seeing anything in my in box? When did you send it? cve73 at yahoo dot com?
I hope it is helpful, and feel free to write back as much as you want to ask further questions. Not saying I'm right, just my experience. xo BD
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Erin
Erin

December 7th, 2011, 1:27 am #7

I'm never tired of hearing from you! I feel like I am stalking you, LOL!! I just can't decide if I NEED to see D.avis versus another doc there.
Ha! Definitely not stalking! What I've gathered from A LOT of review of archives of this board and others is that many of the Cornell MDs are not high FSH friendly, and really Davis is "the guy" for the DOR set. That's why I decided to pay for Davis (although I've since been told it can be covered from my "out of network" benefits- not sure if you have that benefit, but important if you do...). Again though, this is secondhand information and hopefully others will provide you with firsthand knowledge.
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Mrs. McIrish
Mrs. McIrish

December 7th, 2011, 1:35 am #8

I hope it is helpful, and feel free to write back as much as you want to ask further questions. Not saying I'm right, just my experience. xo BD
I got the new email and wrote back.
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Mrs. McIrish
Mrs. McIrish

December 7th, 2011, 1:36 am #9

Ha! Definitely not stalking! What I've gathered from A LOT of review of archives of this board and others is that many of the Cornell MDs are not high FSH friendly, and really Davis is "the guy" for the DOR set. That's why I decided to pay for Davis (although I've since been told it can be covered from my "out of network" benefits- not sure if you have that benefit, but important if you do...). Again though, this is secondhand information and hopefully others will provide you with firsthand knowledge.
I do have out of network benefits but it is a still an unknown price which freaks DH out... Do you have BCBS?
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Marie
Marie

December 7th, 2011, 4:34 am #10

I have consults booked with C.heck and C.ornell (I'm following in Erin's footprints) as I got booted from Brigham in Boston last week following IVF#2. My question: I booked the consult at C.ornell with Dr. S.pandor.fer because he was "in network" where D.avis is "out of network" and would cost a lot more. How important is it that I see D.avis versus Dr. S? I know C.ornell bills procedures through the center but is the consult the only thing billed to the RE? I'm interested in co-culture and did AH for both IVF.

I hate to pay $500 for a consult if I can pay a $25 copay for Dr. S. unless there is a big difference.

With my insurance I have to prepay everything and then submit the bills for a 80% reimbursement but the 80% is only a reimbursement of a "reasonable and customary" charge for the service. So, if C.ornell bills $2K for something, my insurance could decide that the "going rate" should only be $1500, I'd get 80% of $1500 back. That could add up to be a disaster with a $20K charge that my insurance co decides should really be $13K, leaving me with a $10K bill. That's why I'm consulting with Check too. If anyone has actual charges from C.ornell, that would really help. The billing dept ignored my calls..

FYI: I am 38, FSH was 17.3 at last test (E2=82), AMH 0.3, only got 2 eggs on both IVF's with max stims (EPP and MDLP). Very fragmented embies on first try and embies that didn't grow on 2nd IVF (1 and 2 cell on 2dt).
Hi there, I think I can help a bit more with the decision-making process!

You know some of my story now, that I was like Erin - Dr. Davis' patient but saw Dr. Spandorfer for the co-culture procedure (at the time i went to Cornell, Dr. S. was the only one doing it). Though I only saw Dr. S. for a brief spell, I think you'd be just fine going with him, particularly if it puts your mind more at ease as far as finances go.

IMHO and the opinions of many others whose advice I took, the lab at Cornell is one of the main reasons you go there. Somehow, they are supposed to be that much better with all of the procedures - the fertilization process, the growing of the embryos (especially if you do co-culture), etc.

If you go with Dr. S., you could likely sneak in the fact that you've heard online about Dr. Davis and the help he's provided high FSH patients, and I assume Dr. S. would know enough to treat you as Dr. D. would. I imagine they're in consultation all the time and probably in agreement on most counts.

I enjoyed my consultation with Dr. D. a great deal because he was so knowledgeable, professional, kind, optimistic yet realistic, etc., etc., but I'm sure Dr. S. is the same. The only thing that Dr. D. set for me in the end was the medication protocol, and there are only so many of those. I'm sure Dr. S. is familiar with all of them and would pick one that is good for you.

After that initial consultation when the medication protocol was set, I basically never talked to Dr. D. again. Dr. D. happened to be the one scheduled to perform my egg retrieval, but that was just luck. The doctors rotate with that task as well as with the embryo transfer. I said hello to Dr. Davis at the time of my egg retreival, but he looked at me quizically like he didn't remember me, and I didn't press it. You'll see from reading my story that my cycle actually went very poorly (low egg production, dominant follicle, suggestions during my ultrasounds that I convert to an IUI, etc.), so I was embarrassed that I was even going forward with the egg retrieval. Therefore, like I said, I didn't even talk to Dr. D. again.

I heard many times that Dr. D. is wonderful about taking calls and questions throughout the course of your cycle, but I never contacted him, fearing he'd try to talk me into an IUI. A different doctor who conducted my last ultrasound (never saw Dr. D. for any of my ultrasounds) was the one who ok'd my going forward with the egg retrieval. I'm not sure how Dr. S. is at taking calls while a cycle is ongoing.

The only thing I'm wondering is how much you'd save in the end by going with Dr. S. It might be just the cost of the consultation, which is certainly something (I know every little bit counts!) but not as much in the overall scheme of things

I too had a dreadful time working with Cornell's insurance and billing office and am sorry to hear nothing has changed there. Best of luck with the decision; I know it's a hard one!
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