Gettin' Tested!!

LG2793 · November 2013

So after months and months of no AF or O, I'm finally hopefully getting some answers! You can read my story HERE. I am going to a fertility center's seminar tonight and they will be offering a free AMH test. I also got an appointment with my old obgyn, who I love (not the cray cray one mentioned HERE. Warning: That convo gets a little wild!) Hopefully she can do some diagnostic testing to see if I have PCOS or just figure out whatever the heck's going on.

I would rather an RE do the diagnostic testing, but with my insurance, I have to meet my deductible first, which is $1300! We just don't have that money right now.

Question: Do any of you know if having diagnostic testing with an obgyn will be less expensive than going to an RE? I called my insurance company already, and the doc's office also said that obgyn testing would be less out of pocket. Just wondering if anyone has been through this.

Thank you!!

RoastyToasty · November 2013

Unfortunately I am no expert, but I do know several women that got their PCOS or endo diagnosis from their OB. I imagine it would be less expensive.

Mostly I just wanted to say Good Luck!!

Milagros315 · November 2013

I think it really depends on how the testing is coded and how much each office charges and where the tests are performed. For me, it would have been more expensive to have the testing done with my OB than with the RE. I had already met my deductible and all of my tests were coded as "gynecological", so for most tests and visits I just had to pay a copay. However, if I had done the HSG with my OB she would have sent me to have it done at the hospital which would have been a much bigger bill than the copay at my RE's office. On the other hand, it was better for me to get a prescription for blood work and take it to an independent lab than to have it done at the RE's office because that's the only way my insurance would cover it.

Basically, you really need to check out your specific insurance and find out exactly what your doctor is going to charge, because everyone is different. Good luck!

joshua+rebecca11 · November 2013

I have no experience and therefore no advice but I so hope it goes well for you!

Bredins wife · November 2013

I second what PP's said about coding. I was able to get my RE to code everything under PCOS diagnosis/treatment so we are covered 100% for testing. If we have to do IUI or IVF we are 100% OOP, even after we meet our $5000 deductible.

I would love to have your deductible!

Twinkie0612 · November 2013

I did my inital testing with my OB/GYN (who I will not be going back to, long story) and probably would have saved a ton of money if I had did my testing through my current RE.

My OB/GYN's office refused to code any of my tests as any diagnosis other than "infertility." Even my thyroid blood work, which I was due to have done anyway since I have a family history of thyroid problems and it had been 10 years since I had it checked, was coded as infertility. Since I have no infertility coverage under my insurance plan, that means I had to pay OOP for all of my blood work, HSG, and my husband's SA. We spent somewhere around $3,000 when it was all said and done. Also, the lab my OB ordered DH's SA through used WHO standards for evaluation, which are out dated. We actually found out later that he has slightly low morph according to Strict Kruger.

My RE has redone all of my blood work (It's been a year since my initial blood work) and they way they coded it, my insurance covered it all. My insurance also covered my hysteroscopy appointment (in office) and my RE used a medical supply company that was reasonable for the equipment (a few hundred dollars). We redid DH's SA before our first IVF and we only had to pay a "lab fee."

So I thought I would save money by starting with my OB/GYN, but that was not the case at all.

LG2793 · November 2013

I called my insurance, and the lady I spoke with said that as long as diagnostic testing is done in the doctor's office/lab, then it will be covered 100%! Yay!

One thing that did confuse me: At the RE's seminar the other night, I gained a TON of info. At the end, I asked the doctor about Clomid and taking it monitored with ultrasound vs. taking it just monitored with progesterone. I was surprised by this answer! He said that as long as you are taking the low dose (50mg), it is not unsafe to take it unmonitored. He stated that any cysts that would be formed would be small enough to pass during your AF. This was not what I expected him to say!!

*Side note: Before I get blasted, I do not necessarily agree with what he said, just telling you what a very reputable RE in the Atlanta area said that shocked me!

Anyway, now I'm confused again. Hopefully my obgyn appointment Monday will shed some more light on the situation!

Pintobean39 · November 2013

My insurance doesn't cover any infertility treatments. When I talked to the fertility center a few months ago they told me that my insurance will cover some of the initial testing. They know how to code everything for insurance purposes because they do this all the time.

LG2793 · November 2013

Yeah, my RE says on their website that they cannot code something that's not what it's truly for and don't even ask about it..how it's illegal.. etc etc. bummer.

mmb248 · November 2013

LG2793 said:

I called my insurance, and the lady I spoke with said that as long as diagnostic testing is done in the doctor's office/lab, then it will be covered 100%! Yay!

One thing that did confuse me: At the RE's seminar the other night, I gained a TON of info. At the end, I asked the doctor about Clomid and taking it monitored with ultrasound vs. taking it just monitored with progesterone. I was surprised by this answer! He said that as long as you are taking the low dose (50mg), it is not unsafe to take it unmonitored. He stated that any cysts that would be formed would be small enough to pass during your AF. This was not what I expected him to say!!

*Side note: Before I get blasted, I do not necessarily agree with what he said, just telling you what a very reputable RE in the Atlanta area said that shocked me!

Anyway, now I'm confused again. Hopefully my obgyn appointment Monday will shed some more light on the situation!

The "very reputable" RE/fertility clinic in my area often hosts seminars. They're advertised on tv, she's very well-known, well-respected, and her office told me that monitoring wasn't necessary, but if my insurance covered it, then they did it. WTF? Only insured women need to be monitored?

Having lots of patients and a good marketing team does not guarantee a good RE.

LG2793 · November 2013

I had my appointment Monday with my old obgyn, not the crazy one, and can I just say that I love her! Her words were, "Do you mean Dr. ___ prescribed you clomid without doing an ultrasound? Without doing (something something something) tests?! Oh honey, you're in for the works!"

SO now, tomorrow, I will be going in for an ultrasound and the complete works as far as bloodwork goes. I know I have to fast because they're doing an insulin resistant something-or-other, AMH, as well as others I don't remember. I'm just so glad I might be getting some answers as to why I'm not ovulating or having a period on my own.

She did ask me something scary....I didn't really think about early menopause, but my mom went through it in her late 30s/early 40s. Hopefully that didn't pass down to me...

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