Westchester Fertility Financial Policy

Our Fertility Financial Policy

We are committed to providing you with the best possible care and are pleased to discuss our professional fees with you at any time. Your clear understanding of our Financial Policy is important to our professional relationship. Please ask if you have any questions about our fees or your financial responsibility.

Participating Insurances

If we participate with your insurance, we will submit the claim to your carrier for all covered services. For any non-covered services, payment will be responsibility of the patient before services are rendered. Services deemed non-covered by your carrier remain your responsibility.

Non-participating insurances

Payment is due at the time of service. We will provide you an itemized bill which you can submit directly to your insurance company for reimbursement. Please note, this is not a guarantee of payment. Please check with your insurance company for out of network benefits.

Medicare/Medicaid Insurances

We are not a participating provider with Medicare or Medicaid. Therefore, your payment is due at the time of service.

Copays, Coinsurance and Deductibles

By law we must collect your insurance carrier’s copay at the time of service. We will bill you for the coinsurance amount that is designated by your insurance company if necessary. Please note some insurance companies may apply more than one copay per visit and deductibles may apply.

Uninsured Patients

Payment is due at the time of service. Our financial counselor is available to answer any questions you may have.

Missed Appointments

A $25.00 service fee will be charged for any missed appointment.

Finance Charges

A 1.75% interest charge will be applied to any unpaid balances after 30 days.

The finance department can provide general guidelines, but ultimately it is your responsibility to understand your infertility treatment coverage under your plan. Please check with your carrier to verify if any pre authorizations/referrals are required for insurance coverage prior to obtaining any services.

We accept cash or certified bank checks for IVF procedures.

Patients and/or responsible party agree to pay all costs for collection, including legal fees and court costs if the need arises. I have read the above information and agree with the terms.

Signature:________________________________Date:_________________________

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