Calling all RMA Ladies (1st page updates)
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ashknowsbest
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Yeah I think I am a good responder but Dr. said if I'm not pregnant after this cycle then we're going to try one round of injectables. So I'm reallllly hoping this works!
ashknowsbest
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Yeah all with clomid 
Oh and he said my lining was 12mm so that's great too! If this doesn't work, I don't know what will!
Oh and he said my lining was 12mm so that's great too! If this doesn't work, I don't know what will!
DaisyQ
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Ash, that's how I felt about my IUIs too. I have everything crossed for you.
Just know that IUI and clomid is helpful if there is an ovulatory problem, or a mild sperm problem. If you are unexplained, there could be something else going on that IUI/clomid can't address. Last time we discussed it with Copperman, he did say he felt that IUI, if it's going to work, will work within the first few attempts.
My guess is that he wants to try one more IUI with injectables after this, because injectables lead to better quality eggs than clomid. My guess is that if still no BFP after that, he'll recommend IVF.
I have no doubt you'll be prego with in the next few months, in either of these scenarios.
.
Just know that IUI and clomid is helpful if there is an ovulatory problem, or a mild sperm problem. If you are unexplained, there could be something else going on that IUI/clomid can't address. Last time we discussed it with Copperman, he did say he felt that IUI, if it's going to work, will work within the first few attempts.
My guess is that he wants to try one more IUI with injectables after this, because injectables lead to better quality eggs than clomid. My guess is that if still no BFP after that, he'll recommend IVF.
I have no doubt you'll be prego with in the next few months, in either of these scenarios.
.
ashknowsbest
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Yeah, he actually already recommended IVF after this next injectables round. He said especially because of my age and because I'm unexplained we shouldn't really waste much time with IUI because it should work. So, he said IVF end of June beginning of July depending on if this IUI cycle and the next one works or not.
ashknowsbest
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Oh and thanks for the positive attitude It helps when other people are positive for you too! I do have a good feeling about this one though but only time will tell!
It helps when other people are positive for you too! I do have a good feeling about this one though but only time will tell!
DaisyQ
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Ugh. So there is a major hitch in my plans. Maybe. Probably.
My blood pressure is sky high right now...
Anyway - here it is. So yesterday we decided to make the switch to RMA NJ from RMA NY, because we liked the doctor better, it's somewhat more convenient for me for monitoring, ER and transfer, and primarily because of the higher success rates.
So here's the hitch. I just got off the phone with the financial person. It is going to cost us SO much more to cycle at RMA NJ. Not only will my copays be $50, but they way they bill is totally different from RMA NY. Here's how. And keep in mind I have a 10K cap on fertility treatment.
At RMA NY, they bill insurance for the procedure (10K and change for IVF). The contracted rate with my insurance company is 6500 for IVF. That is the amount that gets deducted from my 10K fertility benefit. I have at least 6500 left, so basically, the only thing I will have to pay for is my meds (probably 3K, unless I can use the expired gonal F that my SIL will give me), and $10 copays for monitoring.
At RMA NJ, they bill insurance their rate for IVF ($12,225), and they accept what insurance pays, but then bill ME for the remainder of whatever insurance doesn't pay. So we are responsible for the remaining cost, which could be thousands of dollars - like 6K.
The finance person at RMA NJ is going to call me tomorrow with more specific informatino - what we can expect to pay out of pocket.
Calling RMA NY now to verify the costs of treatment there.
Not sure anymore what to do.
My blood pressure is sky high right now...
Anyway - here it is. So yesterday we decided to make the switch to RMA NJ from RMA NY, because we liked the doctor better, it's somewhat more convenient for me for monitoring, ER and transfer, and primarily because of the higher success rates.
So here's the hitch. I just got off the phone with the financial person. It is going to cost us SO much more to cycle at RMA NJ. Not only will my copays be $50, but they way they bill is totally different from RMA NY. Here's how. And keep in mind I have a 10K cap on fertility treatment.
At RMA NY, they bill insurance for the procedure (10K and change for IVF). The contracted rate with my insurance company is 6500 for IVF. That is the amount that gets deducted from my 10K fertility benefit. I have at least 6500 left, so basically, the only thing I will have to pay for is my meds (probably 3K, unless I can use the expired gonal F that my SIL will give me), and $10 copays for monitoring.
At RMA NJ, they bill insurance their rate for IVF ($12,225), and they accept what insurance pays, but then bill ME for the remainder of whatever insurance doesn't pay. So we are responsible for the remaining cost, which could be thousands of dollars - like 6K.
The finance person at RMA NJ is going to call me tomorrow with more specific informatino - what we can expect to pay out of pocket.
Calling RMA NY now to verify the costs of treatment there.
Not sure anymore what to do.
Helena_
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That's really strange because I was told the opposite. Maybe because of different insurances? You got me all worried now... I hope you work it out and please keep us updated. I really hate insurance (but also love that it covers anything). It really shouldn't be this hard
Daisy - i have the same insurance as you & i think rma billed insurance $9800 or something & i am still waiting to see what my portion is. I figure no news is good news. Also, i have extra meds leftover too & not sure what to do with them now so message me if you get stuck.
Daisy Q: Have your list of questions ready and make sure your financial person is detailed and thorough. My cap was $7,500K plus $2,500K cap for meds. My cycle/meds ended up costing me more out of pkt then expected. So I would def. tack on few thousand to what they quote you. RMA NJ also bills your insurance in phases as the treatment progresses. Not at all once in one lump sum. So you end up paying several time throughout the course of treatment. Orig. they called my meds into Freedom. I then switched to Glen Rock Pharmacy (in NJ) they are a fertility pharmacy and are AWESOME! They worked w/ me and gave me a discounted rate as my insurance did not cover much of the meds. They will mail to you as well if you live far.
DaisyQ
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Girls, you are the best. 
Thank you for the feedback and support.
Helena, honestly I think my finance person has it WRONG. I talked to the people at RMA NY, and they told me that they bill insurance, and as long as you are in-network (which I am, at both RMAs), they must accept the contracted rate, and cannot bill the patient for the remainder. This is assuming that the total amount billed is under my 10K cap. If I exceed the cap, then all bets are off, and I'm paying the full amount I'm pretty sure. I've emailed my financial coordinator at RMA NJ, about this - I don't see how they can bill a patient the remainder of their fee, if they are in-network and accepting the contracted fee from insurance. So in a nutshell Helena - don't stress. I think you are fine.
At RMA NY, I'm pretty sure they just bill for IVF, one lump rate for the ER/transfer (~10K). The lab and US costs are billed separately, and since I work at a hospital affiliated with RMA NY, I only pay a copay. Anesthesia is separate and out of pocket.
At RMA NJ, it appears that everything is itemized, like you said Cheart. It sounds like the $12,225 that she quoted me is an approximate cost, and includes office visits, monitoring, retrieval etc. etc. etc. Every tiny thing.
If I go with RMA NJ, I have to make SURE that they bill appropriately, because not everything should be billed under infertility - the labs and US for example should be coded differently. I'm going to have to be on them like glue to make sure they bill and code things so that they don't use up my fertility benefit inappropriately.
I just looked at the approximate costs and fee schedule, and once I subtract out the costs for US and monitoring, it looks like it's more like $8225, not including ICSI, cyro and anesthesia
Thank you for the feedback and support.
Helena, honestly I think my finance person has it WRONG. I talked to the people at RMA NY, and they told me that they bill insurance, and as long as you are in-network (which I am, at both RMAs), they must accept the contracted rate, and cannot bill the patient for the remainder. This is assuming that the total amount billed is under my 10K cap. If I exceed the cap, then all bets are off, and I'm paying the full amount I'm pretty sure. I've emailed my financial coordinator at RMA NJ, about this - I don't see how they can bill a patient the remainder of their fee, if they are in-network and accepting the contracted fee from insurance. So in a nutshell Helena - don't stress. I think you are fine.
At RMA NY, I'm pretty sure they just bill for IVF, one lump rate for the ER/transfer (~10K). The lab and US costs are billed separately, and since I work at a hospital affiliated with RMA NY, I only pay a copay. Anesthesia is separate and out of pocket.
At RMA NJ, it appears that everything is itemized, like you said Cheart. It sounds like the $12,225 that she quoted me is an approximate cost, and includes office visits, monitoring, retrieval etc. etc. etc. Every tiny thing.
If I go with RMA NJ, I have to make SURE that they bill appropriately, because not everything should be billed under infertility - the labs and US for example should be coded differently. I'm going to have to be on them like glue to make sure they bill and code things so that they don't use up my fertility benefit inappropriately.
I just looked at the approximate costs and fee schedule, and once I subtract out the costs for US and monitoring, it looks like it's more like $8225, not including ICSI, cyro and anesthesia
Helena_
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who's your financial person? What you were describing seemed really odd to me. I haven't actually had to deal with any of this yet, but just from everything bit of information I've been able to read on it, that doesn't happen. I wonder why she told you that. I hate talking to my finance person. It's like pulling teeth to get any info. Like I want to get an idea of my out-of-pocket and I know they have a contracted rate with my insurance, yet she claims that there's no way to know my out-of-pocket until it's time to pay or some nonsense. If there's a contracted rate, surely she knows (or can find out) what that rate is. We're just going to be prepared to pay for the most, but hope it's less. That's actually what she told me I should do. So stupid.
DaisyQ
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Ugh, these people suck. My person is Monica.
I think maybe the reason she can't tell you what to expect is she doesn't know yet all the services that will be billed (how many blood draws, ultra sounds, office visits etc.). But she (or your insurance company) should be able to tell you the contracted rate per service. I'm calling United tonight to find out.
I think maybe the reason she can't tell you what to expect is she doesn't know yet all the services that will be billed (how many blood draws, ultra sounds, office visits etc.). But she (or your insurance company) should be able to tell you the contracted rate per service. I'm calling United tonight to find out.
jchic
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So got back from my IVF appt with Dr. Morris at RMA - basically I am scheduled for a lap on 5/21 and originally she wanted to send me right into an IVF cycle before the lab shuts down from June 20-July 20th but now she is saying that it would be cutting it close to the lap, and she would prefer to do it in August to ensure I have the best success rate possible. So we are doing this:
In the luteal phase of my july cycle I will start estrogen
On CD 3 of my cycle (which would be right around Aug 3-5th) I start my Antagonist protocol for IVF
So hopefully, GOD WILLING by Labor Day I will be pregnant!
I am upset that the original plan was pushed back a bit, but she says that I have a 70% rate of success for a live birth, so given that, I will do what she recommends.
How is everyone else doing?
In the luteal phase of my july cycle I will start estrogen
On CD 3 of my cycle (which would be right around Aug 3-5th) I start my Antagonist protocol for IVF
So hopefully, GOD WILLING by Labor Day I will be pregnant!
I am upset that the original plan was pushed back a bit, but she says that I have a 70% rate of success for a live birth, so given that, I will do what she recommends.
How is everyone else doing?
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