Dr. Braverman

kknapik

I finally have a phone consult with Dr. Braverman on the 24th. For the ladies working with him, if you did a phone consult with him and he was out of network, did your insurance reimburse any portion of the consult? Also, were the labs and meds (Neupogen) covered? He talked about Neupogen and HGH but I don't see how they would be covered by insurance. I am so worried about getting slapped with a huge bill!

 Any info would be appreciated. Would also love to hear your experiences! Thanks!

STL34

**TICKER**  I hope you don't mind me responding.

 

 

My insurance didn't cover any of the phone consults or the lab testing that was done through Reprosource.  The lab Reprosource uses is out of network for me.  So all the lab work went to my out of network deductible which is $6,000.

My insurance covered Neupogen.  It didn't require a pre-certification.  If your insurance requires a pre-certification, it probably won't be covered.

My insurance did not cover HGH for fertility purposes.  And, for HGH to be covered, it required pre-certification.

I used HGH for all 3 of my IVF cycles as my RE recommended it.  Dr. Braverman agreed that it should be part of my protocol.  I also used intralipids for all 3 of my IVF cycles and Dr. Braverman agreed with its use.   But, he didn't think intralipids was enough for me.  That is why he had me add Neupogen for my last IVF cycle.

Good luck! 

kknapik

STL34:

**TICKER**  I hope you don't mind me responding.

 

 

My insurance didn't cover any of the phone consults or the lab testing that was done through Reprosource.  The lab Reprosource uses is out of network for me.  So all the lab work went to my out of network deductible which is $6,000.

My insurance covered Neupogen.  It didn't require a pre-certification.  If your insurance requires a pre-certification, it probably won't be covered.

My insurance did not cover HGH for fertility purposes.  And, for HGH to be covered, it required pre-certification.

I used HGH for all 3 of my IVF cycles as my RE recommended it.  Dr. Braverman agreed that it should be part of my protocol.  I also used intralipids for all 3 of my IVF cycles and Dr. Braverman agreed with its use.   But, he didn't think intralipids was enough for me.  That is why he had me add Neupogen for my last IVF cycle.

Good luck! 

Thanks so much for responding! I have been doing IvIg since Feb. of 2010 and since have had 4 losses and multiple failed cycles so he said he that Neupogen might be worth trying. I figured that it wouldn't be covered (I'm never that luck) but I did see where some women have had it covered so I figured I would check. It is strange how my insurance covers IvIG though. If you don't mind me asking, how much did the HGH cost you? I also wish I knew how expensive the Neupogen is...it really stinks that all of this is OOP. Infertility is so unfair!

STL34

I also responded to your previous post with the cost of some of consults with Dr. Braverman.

My insurance wouldn't cover IVIG.  That is why we went straight to Neupogen.  

I used 3 vials per IVF cycle.  When they were ordered at the same time, it was $750.  My first cycle they ordered 2 and I paid $500 for them.  Then they ordered a third and I paid something like $300 for it.

For the Neupogen, I checked with my insurance before it was ordered.  I knew it was on their formulary, but I didn't know if precertification would be required.  Since it wasn't, it would be covered as no diagnosis is required to be submitted.  That being said, my insurance would only cover it if the prescription was sent to a specific specialty pharmacy.  I had to argue with Dr. Braverman's nurse to get her to send my prescription to that pharmacy.  She just wanted to send it to their usual pharmacy.  However, my insurance told me it wouldn't be covered that way.  So, I was happy that I convinced her to fax it to the correct pharmacy.

Good luck!  I hope Dr. B can figure out a way to help you out!!

kknapik

STL34:

I also responded to your previous post with the cost of some of consults with Dr. Braverman.

My insurance wouldn't cover IVIG.  That is why we went straight to Neupogen.  

I used 3 vials per IVF cycle.  When they were ordered at the same time, it was $750.  My first cycle they ordered 2 and I paid $500 for them.  Then they ordered a third and I paid something like $300 for it.

For the Neupogen, I checked with my insurance before it was ordered.  I knew it was on their formulary, but I didn't know if precertification would be required.  Since it wasn't, it would be covered as no diagnosis is required to be submitted.  That being said, my insurance would only cover it if the prescription was sent to a specific specialty pharmacy.  I had to argue with Dr. Braverman's nurse to get her to send my prescription to that pharmacy.  She just wanted to send it to their usual pharmacy.  However, my insurance told me it wouldn't be covered that way.  So, I was happy that I convinced her to fax it to the correct pharmacy.

Good luck!  I hope Dr. B can figure out a way to help you out!!

Thanks again for the info. Yes, I did see your PP about the consult fees...thanks. Thanks for the warning about the nurse too. I hate when they just try to do things their way because it is easier. I have a feeling I am going to have to fight with them about the labs. Reprosource is out of network for me so I only want the necessary labs sent there and all others sent to a lab that is covered by my insurance. I know that most immune testing must go to them, but I am sure the routine stuff can be done locally. 

What can you tell me about the Neupogen. Any side effects? How much and how often did you have to take it? BTW...a big congrats on your pregnancy!!

STL34

I started Neupogen when I started stims for IVF.  I take a really small amount every day.  I am still on it.  Although I think he usually has you stop by now.  He said he needed to be more aggressive with me.  So, here we are.  I don't really have side effects except occasional injection site bruising.  But, I think that is mostly from the lovenox and BA.