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Click ‘Get Form’ to open the Infertility Authorization Form in the editor.
Begin by entering the Member's information, including Name, DOB, Age, and ID#. Ensure accuracy as this data is crucial for processing.
Fill in Partner's details similarly. This section requires their Name, DOB, Age, and ID#.
Provide Prescribing Provider information including Name, ID#, Phone #, and Fax #. Don’t forget to sign and date the request.
Detail the Member’s Diagnosis by selecting from options like Tubal/Endo or Male Factor. Include any additional notes if necessary.
Indicate the length of time trying to conceive and provide relevant Pregnancy Dates/Pregnancy Outcomes.
Complete sections on requested services and CPT/HCPCS codes as applicable. Attach any required supporting documentation for a smooth review process.

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Which one is better, IUI or IVF?

IUI can be a good starting point for couples facing issues involving ovulation or unexplained infertility. However, IUI may not be the most suitable fertility treatment for a couple. IVF is usually recommended for couples facing the following situations: Severe male infertility.

Are AI and IUI the same?

Intrauterine insemination (IUI) is a procedure that treats infertility. IUI boosts the chances of pregnancy by placing specially prepared directly in the , the organ in which a baby develops. Another name for the procedure is artificial insemination.

How successful is AI insemination?

IUI can be highly effective, especially when fertility drugs are used. The pregnancy rate for IUI when fertility drugs are used can be as high as 20%. The effectiveness of IUI is mostly dependent on the underlying cause of infertility and the age of the mother.

Which is better, IUI or IUI ART?

We do not recommend the use of ART vials for IUI or IVF. ART vials contain fewer motile per vial, so a single vial may not be adequate for an IUI or IVF procedure. ICI (Intracervical Insemination) vials contain seminal fluid along with the cells.

Whats the difference between IUI and AI?

FEP will provide new benefits for FEP Blue Focus, Basic Option and Standard Option members covering artificial insemination procedures with prior approval including intracervical insemination (ICI), intrauterine insemination (IUI) and intravaginal insemination (IVI).