Verified
Verified
This patient has provided documentation of treatment at this clinic.
2021, Successful
Overall, Zinger has been pleasant and will call you back if you request that he call you...Prepare to deal with other members of staff far more often than the doctor himself... I have had most of the scans done by technicians or nurses. My two egg retrievals were actually done by a completely different doctor. I have spoken to my doctor a handful of times and that is merely because I have requested he call me
the nurses [at RMA Long Island IVF] do not often communicate with the doctors, which will result in errors in ordering medication, which can then cost you hundreds of dollars...You will have to ask for any and all results directly, most phone calls will be to tell you “everything looks good” as opposed to actual drawings and measurements unless you ask...Billing is atrocious and the prices they charge are astronomical...
How was your experience with Michael Zinger at RMA of New York - Long Island IVF?
Overall, Zinger has been pleasant and will call you back if you request that he call you however, as many others have pointed out in past reviews about RMA, you will not be seeing him very often until you have a positive pregnancy, which for many women that may mean for months at a time.
What's one piece of advice would you give a prospective patient of Michael Zinger at RMA of New York - Long Island IVF?
Prepare to deal with other members of staff far more often than the doctor himself. Advocate for yourself and be well informed on the whole process prior to starting a cycle at any clinic but especially RMA.
During treatment, were you treated like a number or a human with Michael Zinger at RMA of New York - Long Island IVF?
1. You will very rarely see your assigned doctor, so after doing the research and perhaps choosing one, he or she will not be there for the majority of your procedures. I have had most of the scans done by technicians or nurses. My two egg retrievals were actually done by a completely different doctor. I have spoken to my doctor a handful of times and that is merely because I have requested he call me.
2. Medication coordination is not well researched on their end. Their job, as it was explained to me, was to research the cheapest option for the individual patient. The clinic simply called my default pharmacy (CVS Specialty) and was told it was covered but at 100% patient responsibility. I called RMA to express that I was surprised this was the cheapest option given my experience with this pharmacy. I called the pharmacy and found I would have to pay close to 9,000 dollars for the one cycle. I then had to take the time to do my own research and call multiple pharmacies and compare pricing. I also asked the coordinator whether there were any rebate programs and was told she did not know of any. I then did the research and found Compassion Care and received 50% off three of the main medications after completing their application. When I told her about this, she admitted to knowing about it and congratulated me. In the end the pharmacy I chose cost less than 2500 dollars.
3. Billing will often take a long time to take payment from you because, “We are just that busy.” Meaning, they have so many people to process. That delayed my first cycle of IVF by two and half weeks. This is important given that as you will learn through your own journey, everything is dependent on when your period starts. And yes, this will only add to the sickening feeling that you are literally just a number, a rather expensive one at that.
4. When I started my first IUI cycle of 2021 I was told I would be prescribed 2.5 mg of Letrozole. I explained to the nurse calling with my prescription that in the past for my first three IUI cycles I was given 5 mg and responded well, ultimately becoming pregnant with the third cycle and having my daughter in 2019. I was told they wanted to try the 2.5 regardless. After the first failed cycle I asked to converse with the doctor to better evaluate how to move forward with the second cycle. The doctor then stated that yes, we could try 5 mg instead. I then received a call saying the medication had been sent to my pharmacy and that it was 2.5 mg. When I explained my conversation with the doctor the nurse said to me, “Oh, we just go off the screen when ordering medication and go with whatever was ordered last cycle.”
As for IVF, after my first retrieval, I had 32 eggs retrieved; 21 were mature and inseminated using ICSI; 16 fertilized. The following week I received an update that only three embryos had made it to day five and were only graded as follows: 3BB, 3CB, and 3CB. As for me: I am 31 years old; normal AMH; normal FSH; normal HSG; normal saline sono; unexplained infertility; and many follicles. I have yet to be given a reason that would indicate that there is a direct issue that would have led to only three embryos of good to poor grading to result from an egg retrieval. I then asked to speak to the doctor and he said he was surprised by the results and we discussed what tests could be run, what could be done differently, and what next steps there were. I was then told the protocol in terms of medication would effectively stay the same and based on his explanation I agreed. As the following cycle approached and after speaking to another doctor I was told to ask about potentially increasing the trigger shot (i.e. Lupron), to which he said there would be no difference that he knows of but, “You could try it if you want.” When the nurse called with my trigger instructions and they remained the same I asked if she could verify whether the doctor wanted to make a change and she said to me, “40 IU is what we give everyone.” Overall, it feels as if medication is not something that is tailored to the individual.
As for the medication being ordered, the week of the trigger, I had two separate sonos that showed vastly different results, which were chalked up to “user error.” Based on the vastly different scans this affected the medication protocol. I had completely run out of Gonal-F and Cetrotide and the nurse stated I should order 900 IU of Gonal-F with an additional three to four kits of Cetrotide despite the nurse performing the sono telling me most likely I would trigger that night or the following. I asked the nurse on the phone three to four times whether she was sure and she said absolutely, I even asked if I should order less Gonal-F since I was taking 200 IU at the time, she said yes. After some reluctance I placed the order. The following day my scan showed that I was ready to trigger and I was given a Gonal-F pen and Cetrotide kit from the attending nurse and told to cancel the order. Of course by then it was too late and I now had an additional 664 dollars worth of medication that would go unused. I remember being encouraged after my first egg retrieval to donate any medication that was leftover. So, instead of having me order all that extra medication they could have from the beginning offered me medication from the samples and donations they had. The nurse said she would reach out to the medication coordinator to see if there were something that could be done to help me. It took me asking on several occasions for an update when I finally got an answer that simply they were not to be held liable because it is better that I simply have more medication than not having enough. Again, if this were truly a concern, I should have been offered a dose of each medication from the donation collection as opposed to being told to purchase the max amount of medication.
Describe the protocols Michael Zinger used in your cycles at RMA of New York - Long Island IVF and their degree of success.
Because of my age and the fact that I had a diagnosis of unexplained fertility, no history of losses, and was successful with IUI in 2018 resulting in a live birth for my daughter in 2019 we first decided to try IUI again after trying for a year. After four failed IUIs we moved on and attempted an egg retrieval. Given my antral follicle count being high, I was given a fairly low dose of the standard medication including Gonal-F and Menopur for about a week, which was accompanied by Cetrotide after four days of stims. I triggered the first time using a combination of Lupron 40 IU and HCG. The HCG may have affected my egg quality and although 32 were retrieved, only three made it to blast and took until day 7 to get to that point of maturation. Of the three, two tested normal and the grades were 3BB and 3CB. Despite the fact that they weren't of the best grade and took so long to become a blast, the 3BB was transferred and of course, it failed. My doctor first stated I should try transferring the 3CB however, I did not think that was wise and urged we try again with an altered protocol resulting in my second egg retrieval. Gonal-F was slightly increased and the HCG trigger was removed. The second retrieval resulted in 36 eggs, 23 mature, 23 fertilized, 19 survived to the next day, 14 made it to blast. Of the 14 tested, 10 were normal with the best grades being 4BA, 3AA, and the worst being 3BB. More importantly, all of them made it to blast by day 5.
Describe your experience with your nurse at RMA of New York - Long Island IVF. (Assigned nurse: Gabrielle)
As described earlier in the review, the nurses do not often communicate with the doctors, which will result in errors in ordering medication, which can then cost you hundreds of dollars. There are also various nurses that will draw blood or conduct your sonogram resulting in a mix of experiences and more important a difference in ultrasound interpretation. This can be crucial because for me it gave my team the wrong impression from one day to the next resulting in the wrong medication being ordered, which is costly and will not be used by you.
Also, if they truly cared about your wellbeing, this would also include your financial wellbeing. Therefore, they should offer medication from their donation/ samples when in doubt about whether you need more medication.
Describe your experience with RMA of New York - Long Island IVF.
Before I came to write this review, I had reached out to the patient advocate in hopes of finding a resolution to the financial missteps and at least some understanding as to when procedures resulted in me experiencing pain. I tried over the course of two months to work with someone in hopes of finding a solution and feeling cared for and in the end, RMA will continue to treat you solely as a number.
The IVF billing coordinator is impatient and will often leave you in the dark as you await an answer. Many of the people you will come across lack a sense of humanity and will as other have mentioned yell at you or hang up on you when you try to point out how you have been treated or whether something is inaccurate. Although my nurse, Gabrielle often had made mistakes, she was never rude. I can attest that the other nurse, Jackie, has she has been described in other reviews is mean, impatient, and unapproachable from what I have witnessed on my visits to the office. So, I am thankful to have never been assigned her for my care.
Billing is atrocious and the prices they charge are astronomical as I have mentioned in other areas of this review. If your insurance does not cover fertility treatment, they refuse to submit any portion to insurance at all and therefore you will not have the opportunity to pay the negotiated pricing for treatment. For example, for a beta blood draw, although my insurance would not cover it, they negotiate that it should not cost more than twenty three dollars. During a given cycle, a simple blood draw at the self pay rate will cost you hundreds. Some tests are done outside of a cycle and can be negotiated but that is rare.
Describe your experience with your monitoring appointments at RMA of New York - Long Island IVF.
Because of COVID you would be assigned a specific time slot however, no one enforced this nor did anyone actually follow this so it was first come first seen. Often, a mix up would result in me waiting for an hour or two to have blood drawn because they mixed up the order in which we came in. They often do not book enough nurses to draw blood or complete the sonos so the wait time would often by long for that reason, as well.
Describe the costs associated with your care under Michael Zinger at RMA of New York - Long Island IVF.
The initial cost upfront for a given retrieval and single transfer was 13,250.
Anesthesia - 600.00
Biopsy for PGT Testing - 2,400.00
PGT Testing by outside lab - 150.00 for each embryo, after eight embryos 100.00 each.
HSG (which will most likely be ordered) 900.00.
Saline sono (which will be ordered) 750.00.
So, approximately 17,900 before including how much each embryo being tested will cost you.
Medication was an additional 2,500 the first round.
Describe Michael Zinger's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at RMA of New York - Long Island IVF.
Dr. Zinger explained that given PGS, there would never be a need in transferring more than one embryo regardless of how many failed attempts. Given that I only needed a second transfer I cannot say whether I would have been fine with that philosophy several transfers down the line given that RMA charges 7,000 per additional transfer outside of the full IVF package.
What specific things went wrong at RMA of New York - Long Island IVF?
- Failed to call in prescriptions to pharmacy
- Lost paperwork
- Lost appointments
- Failed to call with results
- Failed to order appropriate test
- Failed to inform you of changes in protocol
- Provided conflicting information
- Failed to convey critical information
- Failed to consider drug intolerance
- Scheduled the wrong procedure
Describe the specific things that went wrong at RMA of New York - Long Island IVF.
1. There is always very poor communication. For example, for the first IUI I received a call saying to report to Melville and my husband received a call to report to Lake Success (where our doctor is located). We later found out that all procedures are actually done at Melville and I had not called and we reported to Lake Success then we would have wasted his sample and missed the window for our procedure.
2. You will have to ask for any and all results directly, most phone calls will be to tell you “everything looks good” as opposed to actual drawings and measurements unless you ask. If you want physical copies, you will have to ask for this and sign multiple medical release forms each time you want the most updated info. Why they do not have an online portal with access to this information is unacceptable; their online portal is only for confirming and cancelling appointments.
3. Their self-pay prices are astronomical. An HSG test is $900 out of pocket, while ten minutes away at a local radiology facility it would have cost max $300 out of pocket but since they bothered to put it through insurance I only paid about $120. I only found out this was an option when I asked if there were other options. Later I found out in the notes that billing took credit for this and supposedly volunteered this information when I first tried expressing my overall concerns to management.
4. Despite asking to be seen by the anesthesiologist promptly to anyone I spoke to in the days prior, I found out I was second on the OR list that day. Upon getting there I found out that I was second out of two. So, despite expressing my concerns they still chose to put someone ahead of me although we arrived at similar times. To be clear, that many follicles are VERY rare so no, many people will not have felt the pain I had felt to the extent that I did.