My new Dr. ran blood work and did an ultrasound to officially diagnose me with PCOS. The blood work was standard for diagnosis of PCOS (FSH, LH, progesterone, prolactin, TSH, venipuncture, estradiol).
Insurance company just denied payment because the "services provided are not covered." Infertility services are not covered under my policy.
However, I do not believe that diagnosing me with a medical condition of PCOS constitutes an infertility service - my husband and I are NOT currently trying to get pregnant. I just came off of birth control and my periods were all over the place and my Dr wanted to confirm I had PCOS so she knew nothing else was wrong with me. I didn't even THINK that this would not be covered because we are not worried about infertility right now!
Anyone else had issues with an insurance company - especially any success in getting an insurance company to recognize diagnosis of PCOS as diagnosing a medical condition NOT as infertility treatment??
I would find out how it was billed by the office staff. It should come under a general physical, and not infertility as far as I know.
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Laura (27) To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts. James (32)
Zoe Cassandra is here! Born 9/21/09 at 6:12pm MST. She weighed in at 7lbs, 5.5oz's, 19.5 inches! To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
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I agree with having the dr check the billing codes. Plus keep calling your insurance company recording date, time, who you spoke to and any results. Write to your insurance also, including a letter from your physician, since they are notorious for forgetting that you called.
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Cindy(29) & Ken(38)
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Two wonderful bonus sons (12 & 15)
July/Aug: 50mg Clomid, BFN
Sept: 100mg Clomid o'd CD 13 BFN
Oct: 150mg Clomid cd4-8
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Yeah I went through this - actually the first time I was diagnosed I was single and just concerned about irregular periods. Not sure how it was billed but insurance covered everything. Then when we started ttc and the doctor wanted to get all the tests done again, we had to pay for everything. What a shock! I didn't think until much later to have asked if the doctor would change the billing codes.
insurance issues 
