Ask any IVF clinic where the hidden costs live and they’ll point to revenue cycle management.
One-in-five medical claims is denied on first submission, and more than half of RCM leaders now see denial rates above 10% every year.
Fertility leaders call RCM a “huge pain point… extraordinarily labor-intensive for clinics to manage insurance claims,” precisely because data and workflows are scattered across systems.
High-cost treatments, patchwork insurance rules, and emotionally charged patient journeys multiply that burden:
Where time (and money) evaporate | Why it hits IVF clinics harder |
Benefits verification | Coverage varies not just by payer, but by plan: every cycle needs bespoke checking. |
Clinical coding | Miss one ICD-10 or CPT and the entire claim stalls, often weeks after the procedure. |
Patient billing | Families need clarity on co-pays, deductibles, and financing options before they commit. |
Denial follow-up | Even a tiny documentation gap can hold tens of thousands hostage in A/R. |
Why traditional fixes fall short
Most fertility clinics cope by hiring bigger billing teams or outsourcing to third-party vendors. Costs drop into operating budgets, while insight into what’s really happening disappears.
Fragmented tooling means:
Intake data never syncs with coding rules
Claim scrubbers can’t “see” the original note
Billing teams chase denials with out-of-date information
Automation only works when the entire journey is connected.
Owning the journey changes everything
At wawa fertility, we treat RCM as a living extension of the clinical and patient experience, not an after-thought. Because the operating system already handles self-booking, intake, encounters, lab results, payments, and follow-ups, we can weave financial workflows directly into each step.
Here’s how it feels in practice:
Stage | Built-in guardrails |
Patient intake | • Eligibility checks fire automatically, so coverage issues surface before the visit. • Demographics and insurance data flow straight into the patient record. |
Encounter & coding | • Smart code suggestions appear as providers document. • A rules engine flags errors in real time, cutting preventable denials. • Claims are scrubbed once, at the source, then submitted. |
Billing & payments | • Up-front estimates break down co-pay, deductible, and OOP. • Patients self-pay or set plans in a portal that syncs to the ledger. |
Financial visibility | • Live dashboards show Days in AR, denial rate, and collections. • Work queues route follow-ups to the right person, automatically. |
No swivel-chair work, no manual re-entry, no black boxes.
What this means for you and your fertility clinic
When RCM is embedded, not bolted on, teams get evenings back, denial rates drop, and cash arrives faster. Patients see clean, predictable bills and trust the process. And the fertility clinic can focus on what matters: successful cycles, not coding checklists.
Fertility is hard enough. Getting reimbursed shouldn’t be.
