Billing Information
While you are in our care at RMA of Texas, we want to provide you with the highest quality of care available in a compassionate and cost effective manner. Our fertility treatment programs are structured to encourage a high level of personal contact with your medical and financial team and we encourage you to utilize these resources. Insurance Coordinator Mary Sifuentes will be able to answer any questions regarding fee schedules, insurance issues, payment options, etc. Please feel free to contact Mary at msifuentes@rmatx.com or call 210.FERTILE ext. 169 (210.337.8453 ext. 169).
Participating Insurances
RMA of Texas participates with the following insurance carriers:
- United Health Care
- United Resource Networks – RMA of Texas is recognized as a Center of Excellence
- Mercy Health Plans
- Blue Cross/Blue Shield of Texas
- Humana
- San Antonio Employers Health Alliance
- Cigna
- Aetna
The extent of coverage, benefits, referral and authorization process vary from policy to policy. It is important that you understand what is covered before you begin treatment, or what the necessary requirements are to get the maximum reimbursement. The finance department can provide some general guidelines on most common policies within each plan.
Some plans require referrals or authorizations. We encourage all patients to check the infertility benefits under their specific plan. Our participation with their insurance does not guarantee coverage for our service.
Non Participating Insurances
Most Point of Service plans allow you the flexibility to choose at the “point of service” to seek medical care out-of-network. If you have out-of-network benefits, please see below.
Step 1
- Confirm that your plan has both out-of-network and infertility benefits.
- Payment is required at the time of service and prior to the start of any treatment cycle. Please call your RMA of Texas Billing Coordinator to discuss financial payment options: credit card, check, cash, wire transfers, or loan programs.
Step 2
- RMA of Texas will provide you with a statement to submit to your insurance provider for reimbursement.
- Depending on your plan, you will receive the percentage reimbursement of charges.
The following is an example of an Out-of-Network Plan. Please note this is only an example; for specific information regarding your plan, please review your out of network coverage with your insurance carrier. You may speak with our Finance Department to review specific dollar amounts.
| Health Options In Network | PPO Plans Out of Network | |
| Calendar Year Deductible | None | $250.00 amount per individual $500.00 amount per family |
| Calendar Year Out of Pocket Maximum | Dollar Amount Deductible Per Individual | $250.00 deductible 80% of Reasonable and Customary Charges* up to $2,000.00 Out Of Pocket, then 100% for the remainder of the calendar year |
| Outpatient Doctor Visit | 100% After $10 copay | 80% of reasonable charges after deductible |
Using the above example and applying to a typical IVF cycle, the following is an approximate cost:
| Estimated Cost for IVF Cycle | $8,750 (1) |
| LESS: Est. Deductible | $250.00 |
| Coinsurance (20%) | $1,700.00 |
| Estimated insurance reimbursement to you for a typical IVF Cycle |
Your insurance company determines reasonable and customary charges. For better reimbursement, you can submit a pre-determination letter that includes the breakdown of fees and CPT codes to your carrier.
(1) Estimated IVF Cycle cost does not include Embryo Storage, PGD, Medications, or services rendered prior to the start of your IVF cycle or after the first pregnancy test.
Refund Guarantee program and package options
If insurance coverage is a concern, RMA of Texas has a collaborative effort with Advanced Reproductive Care (ARC) to offer financial and convenient packages with payment plans. Please call your RMA of Texas Billing Coordinator @ (210) FERTILE (210-337-8453) to discuss the ARC program to pay for your infertility treatment. You can also view ARC's website http://www.arcfertility.com
United Resource Networks ParentSteps Program
Reproductive Medicine Associates of Texas was recently selected as a center of excellence by United Resource Networks and has been enrolled into their ParentSteps program. Through this program, patients who possess very minimal or no infertility coverage become eligible to receive on average a 10 to 20% discount on the following treatments.
- Super Ovulation with Insemination
- Ovulation Induction with Insemination
- In Vitro Fertilization (IVF)
The following procedures will also be discounted if your fertility specialist determines they will be necessary in your IVF treatment plan:
- Assisted Hatching
- Preimplantation Genetic Diagnosis (PGD)
To learn more about this program, contact United Resource Networks ParentSteps Program, toll-free, at 1-866-774-4626 or visit its website at www.myoptumhealthparentsteps.com
RMA Network
