The goal of River North Center for Reproductive Health (RNCRH) is to offer you the most sensitive, comprehensive and technologically advanced care. If you have insurance coverage, RNCRH will make our best effort to coordinate your care in a cost-effective manner within the limits of your insurance benefit and to minimize the expense for which you are responsible. Fertility benefits vary widely by state, insurer and specific plan. The coverage available to you depends on the insurance choices you made with your employer or by purchasing independently.

You are responsible for understanding the details of your insurance plan and we rely on you to keep RNCRH up to date with correct information about your coverage. Please note we are not a party to your insurance contract. Your insurance coverage is specified in a contract between you and the insurance company. RNCRH is not responsible for incorrect information given by your insurance company or failure of your employer to provide accurate information to your insurer about your employment status.

If you are covered by one of our accepted insurance plans and provide a valid insurance card or other evidence of coverage at the time of service, we will bill your insurance carrier for covered services. Covered services are those services for which benefits are available under your health care plan. All services are not covered benefits in all insurance contracts. Additionally, some insurance companies may deem certain covered services as medically unnecessary – despite your physician having good clinical reasons for the required service. Common examples are Preimplantation Genetic Testing (PGT) testing, management of ovulation and cryopreservation/storage of gametes (sperm, oocytes and embryos). Finally, some insurance companies may take up to 30 days to obtain authorization.

In turn, you grant us permission to bill your insurance company for covered services rendered and authorize payments of medical benefits to the practice. Covered services are subject to deductibles, copayments, coinsurance or denied payment– in which case, it will be your financial responsibility to pay RNCRH for services rendered. Prior authorization from an insurance company is not a guarantee of payment. All insurance payments are subject to review of claims submitted. RNCRH will not be responsible if your insurance should deny payment. Payments to RNCRH by insurance plans are subject to audits and may require refunds that make you responsible for amounts refunded. RNCRH staff work with patient(s) to determine possible insurance reimbursement for care rendered, but the ultimate responsibility for payment rests with the patient(s), not their insurance company.

We are sensitive to the cost of infertility treatment and the variability of insurance coverage. As a courtesy to our patients and to provide you with the most effective use of your fertility benefits, we offer financial coordinators to discuss your needs and treatment concerns as it relates to out-of-pocket costs. We strongly recommend scheduling a consultation with a financial coordinator after your physician has determined your treatment plan and/or prior to starting any treatment.

The following may apply depending on the details of your insurance plan:

• We do not bill services your insurance company has communicated are not covered unless a specific circumstance warrants it.

• In cases where your insurance requires your bloodwork to be processed by an external lab, you will receive a separate bill from the lab, and it is your responsibility to pay them directly.

• Insurance plans may require a written referral prior to you receiving service from RNCRH. If this is the case, you must have the referral with you at the initial appointment, or the appointment may be rescheduled. If you choose to proceed without a valid referral, you will be responsible for all charges.

• Some insurance plans are “diagnostic only,” which means they only cover certain tests to determine the cause of infertility but no treatment.

• Some insurance plans place a lifetime maximum on what they will pay toward fertility testing and/or treatment.

Medication Coverage:

Please check with your insurance company about:

• How much of the fertility drug costs will they cover.

• Whether there is a specific pharmacy that must be used for fertility drugs.

• Whether prior authorization is required for fertility testing.

Payments:

• Payment should be made at the time of service for services not covered by insurance. For services covered by insurance, please submit payment within 30 days upon receipt of your statement for patient balance owed.

• You can pay using the following two options:

  • Online: www.rivernorth.com/online-bill-pay (also accessed through patient portal; see Embryo Options below for storage billing)

  • Calling our billing department directly at 847.729.2188

• In cases where your patient balance exceeds 90 days, your account balance will be turned over to a collection agency. Additionally, services provided will be affected, and you may not be able to continue treatment.

• Excluding packages, payments and credits are applied in the order from oldest to most recent balance owed.

• All treatment packages must be purchased 48 hours or more prior to initiating treatment.

• All past due accounts must be paid in full prior to starting a new cycle.

• We will only submit for rendered services using the physician-documented diagnosis.

• If you are unable to keep a new patient physician appointment, we ask that you kindly provide us with a minimum of two (2) business days’ notice. This is done as a courtesy to other patients on waiting lists.

• RNCRH has partnered with Embryo Options to provide you cryopreservation billing and disposition education services. It is required that you pre-enroll in Embryo Options to cryopreserve embryos, eggs or sperm.

For Illinois residents: The Family Building Act requires many, but not all, insurers in Illinois to offer coverage to Illinois residents for infertility treatments. Your RNCRH financial coordinator or office manager can give you a copy of the Act, or you can view it at https://insurance.illinois.gov/healthinsurance/infertility.asp. You may also call the Office of Consumer Health Insurance toll free at 877.527.9431. If you have any questions about coverage, you should seek clarification from your employer and about your insurance plan in writing before you begin treatment.

I have read and understand the policy outlined above and agree to accept full financial responsibility as described. I authorize payment to RNCRH of insurance benefits for claims submitted on my behalf, and I also authorize RNCRH to release any medical information necessary for claim payments. Patients who are married or in a legal union are jointly responsible for all charges incurred.

Last updated: October 26, 2023