Home Specialities Reproductive Health
Patient-funded care
where the money really sits
Fertility-experienced reviewers
chart-level review
Clinic & embryology lab
monitoring through transfer
Revenue recovery
on claims marked paid
The bill arrives at the hardest moment of their life.
Think about when your statement actually lands. A family has just been through weeks of injections, monitoring, hope and exhaustion — and then an envelope arrives asking for $1,500 they didn't know was coming. If the cycle didn't work, you are asking for money at the precise moment they have the least capacity to deal with it. Most people don't refuse to pay because they're unwilling. They refuse because they were never told.
Across the 28 fertility clinics we've analyzed, an average of 5–8% of revenue quietly disappears — through that conversation, through lab work absorbed into a package, and through cycles lost to paperwork. On an $8M clinic that's $400K–$640K a year.
See where it's goingWhat 5–8% looks like on an $8M clinic
The 5–8% range reflects OneMed's analysis of 28 reproductive health revenue cycles; the dollar figures apply that range to an $8M example clinic. Your actual exposure depends on payer mix, coverage mandates in your state, case mix, and front-end workflow.
Three weeks isn't a delay. It's a cycle.
Everywhere else in medicine, a slow approval means a frustrated patient and a later appointment. Here it means a window has closed. You can't reschedule biology, and you can't bill for a cycle that never happened — so the paperwork doesn't just cost you time. It costs you the whole thing.
Her cycle doesn't negotiate.
The approval, meanwhile:
Illustrative of a pattern we see often. Approval requirements and turnaround times vary by payer, plan, and state.
Five ways the work gets done and the money doesn't.
None of these are clinical problems. Your pregnancy rates are strong — that was never the issue.
The bill they never saw coming
Fertility care carries real out-of-pocket cost. When coverage isn't checked precisely and the expected balance isn't discussed before treatment, the whole thing lands as a surprise weeks later — often after a cycle that didn't work. The family feels blindsided, disputes it, and it becomes bad debt.
The approval that arrived too late
In fertility, timing isn't a convenience; it's the treatment. When a medication or cycle approval is faxed and never tracked, weeks pass and the window closes. The cycle is delayed or cancelled, the patient is devastated, and there's no revenue because there was no cycle.
The lab work folded into the package
Advanced embryology work is highly specialised, expensive, and genuinely distinct from the base cycle — your most experienced people, your best equipment, your longest hours. It's frequently treated as part of the package price and paid nothing at all.
The cancelled cycle nobody billed
A cycle cancelled on day eight isn't a cycle that never happened. Monitoring scans were done, bloods were drawn, medications were dispensed. When there's no clear process for what to bill when a cycle stops, that care often goes unbilled entirely — or lands on the patient incorrectly, which is worse.
Diagnostic and treatment claims crossed
Coverage in fertility is a patchwork: some investigation is covered, much treatment isn't, and the line between them is thin. File a covered investigation the wrong way and it denies. File monitoring as though it were routine care and it denies. Each one is rework, delay, and a patient asking why they got a bill.
Bandwidth, not effort
Your team is holding a lot at once — a lab, a schedule, and people going through the hardest year of their lives. The money is what gives.
The hardest conversation, at the worst time
Nobody wants to talk about money with someone who's just had bad news. So it gets deferred — and a deferred conversation becomes a statement in the post, which becomes a dispute.
Complexity plus emotion
Your team is running a lab, a schedule, and caring for people at their most fragile. Checking whether every payment matched every contract is not what gives, and shouldn't be.
You can't see it from the deposit
As the owner, you get one number a month. Absorbed lab fees and cycles lost to paperwork are invisible from there, and you can't manage what nothing shows you.
Settle the money before the cycle starts.
Almost everything here is a sequencing problem. The financial conversation, the approval, and the expectations all belong before day one, not after. Do it then and patients are not ambushed, cycles are not lost, and you are not chasing anyone. All inside the systems you already use, with no disruption to your clinic or your lab.
Have the money conversation first
We help your team check coverage precisely and give each family a clear, honest picture of their cost before treatment begins. Not a harder conversation, an earlier one. People pay what they expected, and they rarely pay what shocked them.
Own the approvals
Approvals get tracked as the clinical deadlines they actually are, chased on a schedule rather than as a hope, so treatment windows are not lost to a fax nobody followed up.
See what the cycle actually paid
Our ClearView dashboard shows you where a payment came in below what the care should have paid, including absorbed lab work and underpaid monitoring. Our fertility-experienced reviewers check it against the chart and build the appeal.
Bill the care you actually gave
When a cycle is cancelled, there is a clear process for what was delivered and what can be billed, so scans, bloodwork, and medications do not disappear and nothing incorrect lands on the patient.
The 2026 OneMed Reproductive Health Profit Index.
We aggregated the anonymized results from every fertility clinic we worked with over the last 18 months — here's what surfaced once someone looked at where the money was actually going.
28
fertility clinics analyzed
185,000+
claims reviewed
$195K
average recovered per clinic
↓ 35%
average bad debt
Approval turnaround fell by 14 days on average — which in this specialty is measured in cycles, not calendars. Here's where the recovered money had been hiding.
| Where the money was found | Share of what we recovered |
|---|---|
| Advanced lab work absorbed into the cycle price | 28% |
| Balances that became bad debt | 24% |
| Cycles saved from approval delays | 21% |
| Diagnostic and treatment claims filed correctly | 16% |
| Cancelled cycles finally billed for care given | 11% |
Aggregated across OneMed reproductive health engagements over the trailing 18 months. Individual results vary by clinic, payer mix, state mandates, case mix, and starting point.
Who We Serve?
Revenue recovery and full-cycle billing for fertility care.
Fertility clinics with embryology labs
Clinics carrying serious lab overhead, where absorbed advanced work hits the margin directly.
Independent reproductive endocrinology
Owner-run practices where every unbilled cycle and every written-off balance lands on the bottom line.
Multi-site fertility networks
Groups needing the same financial conversation and the same standards in every location.
Hospital-affiliated reproductive medicine
Fertility services inside larger organizations, where coverage rules and patient billing get complicated fast.
Your claims data, handled properly
A BAA is executed before any claims data is shared, and everything is handled in a controlled, auditable environment.
See it in your own numbers.
You shouldn't have to hand a new vendor months of patient records to find out whether this is real. Pull ten recent payment records, black out the patient details, and we'll walk through them with you — showing where the payment came up short and where the front end is leaking.
- 1 · Pull 10 payment records — a mix of monitoring, cycle procedures, and advanced lab work from your biggest insurer.
- 2 · Black out the patient details — names, dates of birth, and member IDs come out. We work from the amounts.
- 3 · Send them securely — they go into our secure portal before the call.
- 4 · See it live — where lab work was absorbed, monitoring was underpaid, or balances are turning into bad debt.
Book your 15-minute review
We'll confirm a time within one business day.
Common questions.
Why is fertility billing unlike other specialties?
Because a large share of the money comes from the patient rather than an insurer, and because treatment runs on a biological clock. Both facts mean the financial work has to happen before the cycle starts. Once it is underway, you cannot pause it to sort out coverage or reschedule a window that has closed.
Isn't this just about collecting more aggressively?
No. Aggressive collection after a failed cycle is where clinics lose both the money and the family. The better approach is earlier and gentler: a clear, accurate cost conversation before treatment begins, so nobody is surprised by a bill they never expected.
What do you actually look for?
Advanced lab work absorbed into the base cycle payment, authorizations delayed long enough to cost a cycle, care delivered during a cancelled cycle that was never billed, diagnostic and treatment claims filed incorrectly, and patient balances that became bad debt because expectations were set too late.
How do you find it?
Our ClearView dashboard shows where a payment came in below what the care should have paid and where authorizations are stalling. Our fertility-experienced reviewers then check the claim against the chart and build the appeal.
What happens on the 15-minute review?
You bring ten recent payment records with patient details blacked out, including monitoring, cycle procedures, and advanced lab work. We show you what came up short live, without a bulk PHI upload.
Do we have to switch billing companies?
No. The review works alongside your current billing, and many fertility clinics start there before expanding.
Protect the family and the revenue
Bring ten claims to a 15-minute review and see what's quietly going missing using your own numbers.