Revenue Cycle Management

Fertility Revenue Cycle Management Built for IVF Practices

A fertility practice generates 10–25 billable service lines per IVF cycle, routes claims to fertility benefit managers most billers have never heard of, and navigates 21 state mandates with different rules. General RCM companies aren't built for this. We are.

97%+
First-pass claim resolution rate
<18
Average days in AR
12–18%
Typical revenue increase after transition
48 hrs
Denial response SLA

Why Fertility RCM Requires Specialists

Fertility billing sits at the intersection of reproductive medicine coding, insurance mandate law, embryology lab billing, and fertility benefit manager networks — a combination general RCM companies are not equipped to navigate.

Fertility benefit carve-outs

Progyny, WINFertility, and Maven Clinic manage fertility benefits separately from the primary insurer. Submitting to the wrong payer produces immediate denials with no appeal path. We identify carve-out coverage at eligibility verification — before the first claim.

Multi-phase cycle billing

A single IVF cycle spans stimulation monitoring, retrieval (58970), fertilization (89250), extended culture (89272), biopsy (89290), cryopreservation (89258), and transfer (58974/58976) — often across 2–3 weeks and multiple dates of service. Each phase needs its own claim, documentation, and coding.

Dual NPI claim tracks

Physician services (58xxx, 76830) bill under the provider NPI; embryology lab services (89xxx) bill under the laboratory NPI or separate tax ID. Mixing these tracks produces duplicate-claim edits and coordination-of-benefits denials that take weeks to untangle.

State mandate variability

21 states mandate fertility coverage, each with different cycle limits, diagnosis requirements, S-code obligations, and employer exemptions. New Jersey, Illinois, and Massachusetts have among the most comprehensive mandates; Texas and Florida have none. Patient coverage depends on both the plan and the state where it was issued.

Authorization per cycle component

REI prior authorization is not a single approval — it is a separate authorization for IVF retrieval, embryo transfer, FET, PGT, donor sperm/egg, and sperm retrieval. Each has its own medical necessity criteria, expiration window, and documentation requirement. One missed auth can deny a $6,000 claim.

ICD-10 specificity requirements

Payers require the most specific diagnosis available: female infertility by etiology (N97.0–N97.9), male factor (N46.x), PCOS (E28.2), POI (E28.31), structural anomalies (Q50.x). Using unspecified codes triggers medical necessity reviews and underpayments across all claim types.

Our 8-Stage Fertility RCM Process

Every stage is handled by staff who work exclusively in fertility — not generalists who occasionally see an IVF claim.

01

Eligibility & Benefits Verification

We verify active coverage, fertility benefit riders, deductibles, OOP maximums, and lifetime cycle limits before every treatment cycle — not just at the first visit. Progyny, WINFertility, and other carve-out benefits are identified upfront so claims route to the correct payer from day one.

02

Prior Authorization Management

IVF, FET, PGT, donor cycles, and sperm retrieval each require individual authorizations that expire independently. We submit, track, and renew every auth — with payer-specific medical necessity documentation — so no claim is submitted without active coverage.

03

CPT & ICD-10 Coding

Our AAPC-certified coders assign the correct procedure codes (58970, 58974, 58976, 89250, 89258, 89290, 76830, and more) and diagnosis codes (N97.x, N46.x, E28.2, Z31.x) for every service line. Multi-phase IVF cycles are unbundled correctly across retrieval, fertilization, culture, and transfer dates.

04

Claim Submission & Scrubbing

Claims are scrubbed against payer-specific edits before submission — catching modifier errors, NPI mismatches, and bundling conflicts that produce avoidable denials. Physician and embryology lab claims are coordinated to submit on the correct NPI/tax ID track.

05

Payment Posting & Reconciliation

ERA/EOB auto-posting is reconciled against expected reimbursement schedules. Underpayments are flagged automatically. Every fertility cycle is closed only when all service lines across the full treatment episode are accounted for.

06

Denial Management & Appeals

Denials are worked within 48 hours of receipt. We distinguish medical necessity denials (clinical appeal) from technical denials (corrected claim) and authorization issues (peer-to-peer coordination). Our fertility-specific denial library covers every major payer denial reason code.

07

Patient Financial Services

Benefit explanations, cost-of-care estimates, payment plan setup, and patient statement management — delivered in plain language. We reduce front-desk burden while improving collection rates on patient-responsible balances.

08

Reporting & Analytics

Monthly dashboards show collection rate by CPT code, denial rate by payer, AR aging, days-to-pay, and first-pass resolution rate. You see exactly where revenue is leaking — and what we are doing to recover it.

Who We Serve

Solo REI practicesSingle-physician practices that need full RCM coverage without the overhead of an in-house billing department.
Multi-physician fertility groupsGroup practices with 2–20 REIs across multiple locations, coordinating physician and lab billing across NPIs.
Hospital-affiliated fertility programsAcademic and hospital-based fertility programs with institutional billing requirements, credentialing coordination, and complex payer contracting.
Free-standing ART laboratoriesEmbryology labs that bill independently for 89xxx services and need coding expertise specific to the lab service line.
Practices transitioning from in-house billingPractices moving off in-house billing or a general RCM company that has struggled with fertility-specific claim complexity.

Related Services

See how EasyRCM improved collections for a New England REI group practice.

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