New Patient InformationNew Patient InformationWelcome!Welcome!

Thank you for scheduling an Thank you for scheduling an appointment with Reproductive appointment with Reproductive Resource Center. A confirmation letter Resource Center. A confirmation letter will be arriving soon confirming your will be arriving soon confirming your appointment date and time of arrival.appointment date and time of arrival.

Please contact me with any questions Please contact me with any questions you may have. We look forward to you may have. We look forward to seeing you soon!seeing you soon!

Carol M. ReeseCarol M. ReesePatient CoordinatorPatient Coordinator913-894-2323913-894-2323

Consultation FeesConsultation Fees

General Consultation - $150 to $400General Consultation - $150 to $400– General consultation with lab and ultrasound ~ $550-General consultation with lab and ultrasound ~ $550-

$700$700 IVF Consultation - $300 to $400IVF Consultation - $300 to $400

– IVF consultation with lab and ultrasound ~ $700-$900IVF consultation with lab and ultrasound ~ $700-$900

Note: As shown above there may be additional services performed Note: As shown above there may be additional services performed (ultrasound & lab work) including infectious disease screening which (ultrasound & lab work) including infectious disease screening which is a requirement prior to beginning treatment. Examples are shown is a requirement prior to beginning treatment. Examples are shown above. above.

The initial consultation and additional services may be covered The initial consultation and additional services may be covered under your insurance plan.under your insurance plan. If you do not have insurance, all fees If you do not have insurance, all fees relating to your initial consultation for you and your partner are due relating to your initial consultation for you and your partner are due upon checkout. upon checkout.

RRC accepts all major credit cards for your convenience.RRC accepts all major credit cards for your convenience.

We encourage you to contact your insurance carrier so you are We encourage you to contact your insurance carrier so you are aware of your infertility benefits/coverage. aware of your infertility benefits/coverage.

Let’s get started…Let’s get started…

The following information is designed to give The following information is designed to give you valuable insight on treatment costs and you valuable insight on treatment costs and options prior to your initial consultation.options prior to your initial consultation.

After Dr. Riggs or Dr. Brabec have established a After Dr. Riggs or Dr. Brabec have established a treatment plan for you, myself or another treatment plan for you, myself or another financial counselor will meet with you to financial counselor will meet with you to review insurance coverage/benefits and review insurance coverage/benefits and establish your downpayment to RRC. The establish your downpayment to RRC. The downpayment is based on the information we downpayment is based on the information we received from your insurance carrier and will received from your insurance carrier and will be due at the start of your treatment cycle.be due at the start of your treatment cycle.

Medical RecordsMedical Records

REMINDER:REMINDER: Follow up with any Follow up with any physician’s office where you have physician’s office where you have requested medical records to ensure requested medical records to ensure we receive them at least one week we receive them at least one week prior to your initial consultation.prior to your initial consultation.

Additional Consents to Release PHI are Additional Consents to Release PHI are available on our web site under Patient available on our web site under Patient FormsForms

Insurance CardsInsurance Cards

REMINDER:REMINDER: If you have not sent a If you have not sent a copy of your insurance cards for copy of your insurance cards for both you and your partner, please both you and your partner, please fax front and back copies so we fax front and back copies so we can verify coverage and benefits can verify coverage and benefits prior to your initial consultation.prior to your initial consultation.

Fax: 913-894-0841 Attention: Fax: 913-894-0841 Attention: CarolCarol

InsuranceInsurance

Depending on the type of plan Depending on the type of plan you have, there may be you have, there may be benefits for:benefits for:

Infertility TestingInfertility Testing Infertility TreatmentInfertility Treatment Both Testing and Treatment BenefitsBoth Testing and Treatment Benefits No coverage for Testing or No coverage for Testing or

TreatmentTreatment

We encourage you to call your insurance company to review We encourage you to call your insurance company to review the type of coverage you have for infertility services.the type of coverage you have for infertility services.

RRC ProgramsRRC Programs

General Infertility/IUI (Intrauterine General Infertility/IUI (Intrauterine Insemination)Insemination)

Traditional IVF (In Vitro Fertilization)Traditional IVF (In Vitro Fertilization) ICSIICSI FET (Frozen Embryo Transfer)FET (Frozen Embryo Transfer) Third Party (donor egg, donor sperm Third Party (donor egg, donor sperm

and gestational carrier services)and gestational carrier services) PGS/PGD (Pre-Implantation Genetic PGS/PGD (Pre-Implantation Genetic

Screening/Diagnosis) Screening/Diagnosis) Oocyte VitrificationOocyte Vitrification

We know you have a choice when We know you have a choice when choosing a clinic for your choosing a clinic for your

reproductive needs. reproductive needs.

The physicians and staff at RRC are The physicians and staff at RRC are here to help. We look forward to here to help. We look forward to

seeing you soon! seeing you soon!