IVF billing reminder

We want to remind you that if you are in our network you must bill us for in-vitro fertilization (IVF) treatments instead of charging our members upfront. The same applies for Cigna Healthcare members receiving care in Michigan, due to our Strategic Alliance with them.

Why do we need to bill the health plans?

A number of Priority Health and Cigna Healthcare members receiving care in Michigan have IVF coverage. If we discover a member has IVF coverage after they’ve been charged upfront, there is a long and complicated reimbursement process for both you and your patients. 

Do many Priority Health and Cigna Healthcare members have IVF coverage?

Yes. While it’s not a core benefit, a significant number of our employer groups have an IVF coverage rider.

What if we bill the health plan for a member without IVF coverage?

If the member doesn’t have IVF coverage, we’ll deny the claim and then you can balance bill. Prior authorization isn’t required or available for IVF.

As always, members can contact our customer service teams using the information on their card if they want to know upfront what coverage they have. Cigna Healthcare’s coverage policy for Infertility Services may also be found online.