OB vs RE for HSG with no IF insurance question

[DrHooch]

Hi Ladies,

I had just joined Voldebord when everything went down, so I'm still fairly new. I've tried to put my relative info in my sig, hopefully that worked. So glad that these boards got up and running so fast. I was heartbroken when I thought I'd finally found a support system and then it vanished. So thanks!

I am (probably, admittedly over-) worried about my upcoming HSG. I've been working with my OB because my insurance doesn't cover anything IF. After hearing from a lot of you that I should switch to an RE prior to treatment, and that some REs don't accept tests done with OBs, I am wondering if I just shouldn't suck it up and reschedule the HSG with an RE. If everything is normal, I'll need to see an RE anyway. If a tube or two are blocked, I'll still need an RE, right?

The reason I'm worried, though, is that AF is due in the next week so if I am going to reschedule with an RE I need to do it like yesterday or I'll have to wait another cycle. So, what would you do?

Thanks!

[bluefairy5]

I suppose all practices are different, but my RE referred me to an independent imaging center (the same place I had the u/s that dx'd my PCOS, actually). I'm not sure how many OB offices can actually perform true HSGs because it's an x-ray procedure, and many OB offices don't have x-ray facilities. (I suppose if they're lumped into a hospital or larger ambulatory care center it's different, though.)

I would be very surprised if you had your OB order the HSG and the RE didn't accept the results. You can always call the RE you're thinking about using, though, and just double check with them. Let them know you're OOP for anything IF. My RE originally wanted to send me to a different HSG spot, but they were out of network for me, and he ended up being fine with my place. And yep, if you have blocked tube(s) you'll need to go to an RE. GL!

p.s. I'm total crap at math (and thereby chemistry) but I am a huge fan of your avatar

[Deleted]

Jan 21, 2015 10:42:03 GMT -5 @ketchup said:

Hey and welcome over here! I did my HSG with an OBGYN because I didn't want to waste time while I was waiting for my initial consult with my old RE. While some tests (such as an SA and b/w) may be re-run by your RE, it is unlikely that you'll need to repeat the HSG done by an OBGYN, especially if your tubes are clear. Just make sure that you get a copy of the CD with images, or at the very least a copy of the Radiologist report, and give it to your new RE when you submit your new patient packet.

Tips for day of: Take 800mg Ibuprofen an hour before your test. Bring a pad (in case they don't provide one) and don't wear your favorite pair of panties - there will likely be leakage of the dye and you may have some spotting for the rest of the day. REMEMBER TO BREATHE. Clenching your ass cheeks and gripping the table like your life depends on it will only make the insertion of the catheter that much more difficult, so keep telling yourself that it will be over before you know it. GL!

Aaallllll of this! I did my HSG with my OBGYN too, and my RE had no problem taking that information. So I didn't have to re-do it. We did have to re-do b/w and the SA again though, but that's NBD. 
Go for it, and good luck, I hope everything is clear.

[lindy04aggie]

PP's have given great advice. I just wanted to say welcome and good luck!

[dancerspose]

Does your insurance not cover testing and treatment? Mine doesn't cover anything IF treatment wise, but did cover testing so they didn't care whether it was done by an RE or OB. I'm sure you already checked, but I just thought I'd clarify. Either way, I second bluefairy5 suggestion of calling the RE you think you may use (or a few if you have multiple options) and see if they'll accept outside testing. That way you'll at least be fully informed.

[kensie5226]

I think you'd be fine with an OB. I did mine with an RE, but it's not the RE I am seeking treatment with. It was actually this RE's behavior at the HSG which motivated me to seek a better doctor. The new RE has no issue taking the results of the procedure. The one thing I will say is ask for a copy of the report ASAP. I had a bitch of time trying to get a copy of the new results from the old office. As a matter of habit, I would suggest asking for a copy of all tests that you have done so that you are able to bring them to any future RE appointments.

[Ann612]

Actually, I was under the care of an RE and their normal person who does the HSG was out, so they actually recommended I call by OBGYN to see if they do them. They were just very, very specific that I get a CD of the image. That way it's like they were watching the results anyway.

So yeah, all of what @ketchup said

[DrHooch]

Thanks for all of the advice! Not sure if the "@" things works the same as VB, but here goes:

@ketchup - I will do my best to keep all that in mind!

bluefairy5 - My OB is in a facility right next to the hospital, so I think they can do it there. My US and BW have all been in the clinic, too. Also, thanks for the avatar love! I'm a chemistry prof, so usually I hear about how much people hate it - it's nice to hear the opposite!

@dancerspose - My insurance doesn't even cover testing. I've checked and re-checked because I just can't believe it. I get why they won't cover at least some of the treatment (Catholic college) but not even diagnosis? So frustrating.

ET fix my @s - not sure why the last one isn't working!

[lillee]

Hello and welcome. I think testing with an OB is fine, I just would go to an RE for treatment. My HSG wasn't too bad. I had a little cramping but the anxiety before was the worst part. I know everyone has a different experience. I did my HSG, endo biopsy, and a laparoscopy with my OB. Once he got the lap results in confirming endo, he sent me to an RE for treatment. I went to 2 RE's with the results and they both accepted the tests.

[lemonliz]

Yup, my OBGYN did my HSG! Your RE will review the actual scans (not just your OBGYN's report on the results). With my results, my OBGYN declared it "normal" but my RE disagreed and sent me back to my OBGYN for a lap. FWIW, he was right.

[deelopi9]

I had mine ordered through the OB/GYN and it was scheduled at an outpatient center. Both RE accepted confirmed it was acceptable. Good luck, I agree with @ketchup take 800mg of tynenol the cramps were uncomfortable.

[bluejoan]

Does your insurance cover HSG to check for a blockage? I forget how my RE coded the test (at work now and it was almost 2 years ago) but it wasn't IF code related at all and insurance picked up a portion. Now if my OB had done it, they would have coded IF. See if you can get the codes and see if your insurance will cover that code.

[DrHooch]

bluejoan - Somehow, my OB has been really good about getting my insurance to cover things I didn't think they would, which is why I was planning to stick with her as long as possible, but I'll look into that!

[Sha259]

I think it's completely fine to do some of the initial testing through your GYN before going to an RE. If you feel that your relationship with them is good, and that they do really have your best interests at heart, then they should have no trouble referring you to an RE they trust when and if they feel that they can no longer be of help to you. The only reason I started out everything with an RE is because my insurance at the time did cover at least to the diagnosis of infertility (so all testing, U/S, and surgeries were covered).

Now if when everything comes back and they then offer you Clomid in a candy basket...that's when you run.

Good Luck!