Beth Rackow

I don't know if Dr. Rackow is really familiar with many of her patients' cases/treatment progress. She was seldom available and I only managed to see her once. Again, I feel that fertility treatment protocols are quite individualized and it is very hard for me, as a patient, to just see whomever is available that day and you can tell they just literally just flipped through your chart moments prior and are now going to decide the course of your treatment. It might be okay with some people, but since I was paying fully out of pocket I was not going to take that gamble.

At my first appointment, Dr. Rackow was more than 2 hours late. She apparently had an emergency at the hospital. I understand OB emergencies happen and as a health care provider myself, I know it happens. What I don't understand is the front desk staff, they knew she was running late when I checked in but never said anything. It was only when I overheard the front desk telling other patients to either wait or reschedule that I went up to the front desk myself to inquire, since I had waited nearly an hour by now. At this point they told me that I actually hadn't been waiting that long because they allow 45 minutes of the new patient appointment for us to fill out paperwork. I'd never heard of this and I've never needed 45 minutes to fill out new patient paperwork. They then basically said I could come back another day or reschedule. Dr. Rackow's schedule is not very frequent and I had already canceled my patients for the day to see her so I opted to wait, I got lunch at Whole Foods and then came back to the appointment. The entire time the front desk seemed to not care and never bothered to inform me that she was going to be in late. I stayed to Columbia against my better judgement (I also trained there so I guess I felt some sense of loyalty), but after the cattle-call morning monitoring visits where I without fail would have to wait nearly an hour and a last minute appointment cancellation by Dr. Rackow, I left the clinic after finishing the infertility/RPL workup. I could not even get a follow up to discuss the results because Dr. Rackow is just never there. I had it with Dr. Nataki Douglas. I made the appointment for first thing in the morning to minimize wait time. At 20 minutes past my appointment time, I saw Dr. Douglas and some staff roll in the office with coffee and doughnuts, apparently they had gone out to get coffee and no one seemed to care that there were patients on the schedule. That really solidified it for me. Since I was paying fully out of pocket, I felt I couldn't do treatment at Columbia because it just seemed like no one cared at the office. To me, fertility treatment is quite individualized and when I finally saw Dr. Douglas, I could tell she just read my chart right before the appointment and offered standard treatment options without taking my medical history into consideration.

My insurance only covered up through diagnostic testing. I left after the diagnostic testing. Did not start treatment at Columbia. Little did I know I would be haunted by billing issues for another 9 months. PLEASE CHECK YOUR BILLING STATEMENTS!! I will highlight 2 issues: 1.) On my first visit with Dr. Rackow, as you see from above, was delayed greatly, and Dr. Rackow spent approximately 30 minutes with me going over my medical history and then suggested some lab tests. I was then shuttled off to speak with a nurse who went over when I was supposed to come in for baseline bloodwork, since I was an IVF newbie. Imagine my surprise when I then got a bill from Columbia for $404 for a 60-minute office visit with Dr. Rackow. They billed under code 99205, look it up if you're curious but I guarantee you the criteria under which the clinic was allowed to bill under that code did NOT happen at my visit. Obviously I did not "clock in" or "clock out" the visit but honestly the least amount of time I spent at that office was the actual appointment with Dr. Rackow. When I called the office to inquire, the billing department said they would speak with her and get back to me. They actually did call me back, only to tell me that Dr. Rackow said she had spent a significant amount of time that I was definitely there for an hour. I'm not even sure if Dr. Rackow remembered me as a patient and I thought it was pretty impressive that she remembered how long she spent with me. The ironic thing is when I had another new patient consult with my current RE at another clinic, I was bracing myself for another $400 visit. My new RE saw me on time, ACTUALLY spent over an hour for the visit, and the office only billed my for a 45 minute visit, which was only $118 out of pocket for me. 2.) I was double billed by Columbia for lab tests. Columbia did the blood collection but the analysis gets sent to another lab, typically Enzo Labs. There was a lag by Enzo labs for some genetic tests since they had to verify some things with my insurance so I got the lab bill from Enzo almost 9 months (yea....) after the date of service. I cross referenced it with the bill from Columbia for the same date of service, which came shortly after the office visit to draw blood (sending out bills is one thing they are not slow about), and noticed that Columbia had billed for the blood collection, as well as for the analysis of 3 hormones, under the same code as Enzo Labs, who actually did the analysis. I could not believe I had to call Columbia... again. I thought I was done with them. Spoke with Sara in billing, who told me that she would call me back in a couple of days to let me know what the credit owed to me was. I never got a call back, and when I called after a week Sara no longer worked there! They then transferred to me Sofia Papaderos, the financial services manager, who actually was pretty good about emailing me back at first. However, I found it strange that the manager could not give me a timeline of when or how the credit would be processed (apparently the credit needs several approval signatures prior to issuance of a refund check, again, something you would expect the manager to know about). She then proceeded to tell me that an amended claim needed to be filed with the insurance prior to me getting the refund, but Columbia never sent this amended claim, and again, her exact words were "Not sure on the time frame unfortunately". Then I stopped hearing back from her all together! After over a month of back and forth, I finally somehow just received a refund check in the mail, without needing this so-called amended claim.

I think I spend more time reviewing Dr. Racow than she spend on my case. When I had a follow up appointment she was searching through her computer data for the information about my case as she was unprepared. Most of the visit she was staring at the computer instead of giving us advises or talking about our case. After unsuccessful treatments she wanted us to continue with the same treatment without adjusting anything. Getting questions answered while in a cycle was challenging. There was no email or phone for Dr. Rackow. I left only one message but it was not returned. It felt like you have no one to turn with your questions.

Have as many questions ready as possible. Write them down and go through them. Don't get rushed answers as satisfactory.

The visits were very rushed. Any questions I had Dr. Rackow explained fully, however she did not volunteer to give me any information by herself. I learned more about my procedures from the internet than from my own doctor. It takes a month to schedule an appointment (which doesn't last more than 10 minutes) because she is in the office only once a week for half the day. You cannot contact your doctor with questions. Instead, you need to call the office and talk to the nurse. If you have a question for the doctor then the nurse takes the question and it is supposed to be answered in 24 to 48 hours. However when I left a message with the nurse - my call was never returned. If you need immediate response then I think there is a fee for that. Doctor never followed up on the results. Dr. Rackow"prescribed" 3 cycles and then asked me to return for "follow up" visit which also took less than 10 minutes where she suggested I do another 3 cycles without changing the protocol.

Treatment strategies: 50mm clomid, iui, check for pregnancy. result: negative

Nurses and staff do what they are supposed to but without explaining why. Waiting time on average was 2 to 3 hours. But sometimes 4 hours. For one nurse it took 10 minutes to draw blood. She was not schooled at assembling the equipment so she wasted 6 needles before she got it right. I don't believe she had a proper schooling. Other nurses were just ok.

The wait time, very often, is excruciating. 4 hours for iui in not unusual. You are treated like a number. Noone will tell you why or how, they just draw your blood, or take you for a sonogram, however they will not explain what they see (on a sonogram screen). The billing department will NOT response to your calls. I paid the balance every time I was there and somehow they still managed to send some bills to "collection" even though I never got a bill for it. A year later there are some amounts disputed: after calling multiple time for an explanation or bills it is still unresolved. You cannot just talk to the billing department. You may only leave a message.

$4,600 per IUI cycle

N/A

Another cog in the CWRC machine with zero personal knowledge of our case or any real motivation to pull off a successful pregnancy. To give an idea for how bad it was - here is our last visit's description (at which time we decided we are never setting foot again in CWRC) - we had completed 6 IUI cycles by then, with no adjustments made to our medication or plan (we constantly got only one follicle with each clomid cycle) - We setup time with her to figure out if we should move on to IUI. - She spent a good 15 minutes telling us curtly that we should have caught a billing/insurance screw-up that had happened with a blood test earlier in the day (nurse made a mistake with some code, we didn't catch it). - She then proceeded to spend another 10 minutes searching cluelessly through our records and complaining that someone had not organized the records properly. - when we asked for her opinion on whether we should do ICSI and whether we should do PGS with our IVF cycle and she point blank refused to answer, saying it was a decision we should make (we only asked for her expert opinion) - the consult ended at that and we didnt step foot in CWRC after.

Avoid CWRC at all costs. The only reason you go there, and i repeat, the only reason you go to CWRC is if your financial situation requires it (they are not as expensive and accept more insurance plans). If you do have to go to CWRC, avoid Dr. Rackow at all costs. She also btw, only visits CWRC in mid-town once a week for half a day - which means getting time with her for a consult is next to impossible.

Not once did she know the history of our records. The last consult was the last straw for us. She had absolutely no idea about our history and spent the entire time searching for her records on her computer in fits and starts, and ended up spending hardly any time discussing our case history or customizing a plan for us.

Did 6 IUI cycles with Dr. Rackow and was on clomid (though they switched to a different one for a few cycles because of vision side effects). Always got only one mature follicle - never more than one - but she made no changes to the plan.

Its a faceless factory, so there isnt a concept of a specific nurse you work with.

Strengths - they are not as expensive, accept more insurances (this wasnt an issue for us but we have heard this from others) Weaknesses - they are a research institution with zero incentives or motivation to get high success rates with SART. And this will show in every aspect of their operation - from the doctor's knowledge of personal history, to the way billing works to the time it takes for them to return a phone call even for pressing issues (BTW, they dont know the concept of email based communication).

We didnt have any problems with billing

We did 2 IVFs and several IUIs with Dr. Rackow. One IVF was a complete failure, the other resulted in two frozen embryos that are still at CWRC. Shortly after leaving Dr. Rackow and CWRC, we successfully conceived. The issue with CWRC is that they don't test for everything, and don't communicate what they don't test for. In fact, the issues that were inhibiting our fertility were easily solvable, but during our time with Dr. Rackow and the CWRC, every failure was addressed with statistical charts (eg. You are at "X" age, therefore your IVF success % is "Y"). We were told they had tested for everything. They hadn't. We wasted three years and tens of thousands of dollars at this practice. Ultimately, CWRC are proceduralists.. They are not diagnosticians. When we returned to CWRC after having our child, we recapped the ultimate diagnosis of our fertility challenge and the response we got (from a different doctor there) was simply "We don't test for that". Well, thanks for telling us you had tested for everything.

If you get a diagnosis, great. If you get a shoulder shrug and are reminded of the statistical charts, leave. Also... Look at the fertility success statistics at Cornell and NYU (neither of which we went to for our success). They are superior.

She's very nice. However 1.) every failure resulted in being presented statistical charts, not problem solving 2.) after being shown said charts, we were asked what we wanted to do next. We expected expertise and assertive care.

They screwed up constantly, particularly when it came to prescriptions and drug ordering. They cost us several thousand dollars out of pocket unnecessarily.

Dr. Rackow is thorough, honest, focused, empathic, matter of fact and to the point but considerate. She listened to all of my concerns, didn't dismiss me, explained things very well to my husband and I, and allowed us to start the process with the least invasive procedure. (Which, knowing what I know now, would skip if I had to do it over.) She was responsive to my needs and was encouraging. She was very upfront about what might and might not work best. She recognized that I was laser focused about this whole process and was okay with that. I grew to love her so much that I was sad to have to leave her for a regular OB when I became pregnant after IVF. But I was ecstatic that I was pregnant!

She is not warm and fuzzy but is kind and considerate in her own way.

I felt that most doctors involved treated me like a person and not like a number, despite the fact they saw many, many patients a day. That said, I am not someone who needs coddling or a warm fuzzy person holding my hand through everything. I'm all business.

They were kind and kept things upbeat, which was good since they were taking my blood seemingly every other minute.

She was fantastic. Super smart, compassionate. Was only person who mentioned that part of my fertility problem may be related to a genetic defect - and recommended testing. She was right! Knowledgable about acupuncture and efficacy of supplements. In the end didn't need to go through with IVF as her recommendations for supplements worked. Highly recommend.

Trust that she's very smart and do not be afraid to ask lots of questions. No question is too small or insignificant.

She definitely got to know us well, and she and the other doctors were very kind and willing to work with me to make sure I was comfortable. Some had warmer bedside manners than others but all were great. Beth was a great listener, she explained things very clearly and seemed to judge pretty well how much detail we wanted. We found her easy to talk to and nonjudgmental.

This clinic had a clear plan they followed for making sure you had instructions and understood your next steps.

Dr Rackow was very warm and informative, I felt cared for and involved in my care plan and decisions. She had an optimistic outlook and positive attitude but set realistic expectations. I felt as though she cared about me as an individual.

Discussion of clinical plan was a conversation where my thoughts and opinions were valued and considered

Strengths: efficient, warm, nice facilities Weakness: for those who want an extensive plan ahead of time (specific calendar etc) I did not get that, but with a high likelihood of changes I personally didn’t mind that but some might

Out of pocket 6800 total plus drugs