My claim involves a misrepresentation of crucial information regarding a very expensive fertility treatment at West Valley Fertility Center (WVFC). As a result, I was misinformed and ill-advised on proceeding with the prescribed treatment and surgery.

I had an initial appointment at WVFC on March 29, 2007, and provided the office with my insurance information. I mentioned I had recently verified coverage for the treatment and surgery with my insurance company. I was never contacted regarding any problems with my coverage and/or billing my insurance. I did not receive a financial consultation and was never informed about any financial obligations. Any issues with my benefits would have been critical in determining whether to proceed with treatment. The WVFC states their office conducts a thorough insurance benefits check and provides patients with a financial consult. In addition, they state payment for the treatment is due at the time of a baseline exam and before the pretreatment which involves numerous injectable medications. I had a baseline exam on May 4, and started the medication protocol on May 5, 2007. Again, I was never contacted regarding any issues with my insurance coverage and not informed about any financial obligations.

On May 16th, one day prior to the scheduled surgery, I am contacted by a billing agent at WVFC. I am told I have no insurance benefits for the surgery. I would be required to pay $8, 505 plus a fee of $425 for the anesthesia. I was very distressed and did not understand why I had not been given this information sooner. I had already completed the two weeks of injectable medications, numerous blood tests and doctor exams. I had already invested a significant amount of time and money for the treatment and was emotionally invested in the outcome of the procedure.

After the surgery, I contacted my insurance company regarding the conflicting information about my benefits. I was told there was no record of a reverification of benefits by WVFC and no denial of benefits had been issued. I contacted WVFC and was given no explanation regarding the misrepresentation of my benefits and no assistance was offerd to help me resolve the matter. In fact, WVFC not only refused to submit the claim for me, but indicated they would be forwarding information that would disrupt payment on the claim. Again, why had I not been given this information prior to starting my treatment and/or prior to my payment of $8, 505? Why was I not given a financial consult which would have prevented this entire situation.

Two weeks after the surgery, I am contacted by WVFC and told the procedure was unsuccessful. This treatment was very stressful, both physically and emotionally and now I had acquired an unexpected financial responsibility. The misrepresentation of vital information and the financial mishandling of my case created a considerable hardship and may have contributed to the failed outcome.

I am submitting this complaint to warn future patients about the practices at WVFC. Patients are often very emotional and vulnerable with this type of treatment. Because of this, they are subject to being misdirected and could make an ill-advised decision with their treatment.