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Information regarding the benefits and cost of
requesting an online consultation from Dr. Kofinas

Welcome! Glad to see you are ready to learn more about the potential reproductive challenges that you may face and to take advantage of high-quality management.  It is the hope that with this information you will be armed with the knowledge that will help you realize your reproductive goals and the dream of motherhood.  If you are here on this page, you have already identified with one of the three groups listed earlier, depending on what is your main reproductive difficulty, and you are ready to learn more. At the end of this page, you will be given the chance to move on with the consultation process. 

The cost for the consultation is the same regardless of what reproductive difficulty category you choose. The work required by us to identify your reproductive pathologies and provide you with specific, actionable, and successful advice is the same, regardless of your category. 

Every patient is unique in many ways that could affect fertility and reproductive health. Even patients with similar reproductive concerns are unique in many ways that should not be overlooked.  In reproductive health, one size does not fit all and even the same couples can be vastly different every time they attempt to conceive. Our bodies change every moment, just like a running river. One could never step in the same river water twice!

Humans are complicated creatures; in addition to the physiological anatomical functions common to all mammals, we have complex emotional brains that could make or break our chances to conceive and have a healthy pregnancy. It takes a healthy mind in a healthy body to achieve healthy fertility!

Fertility difficulties can lead to serious problems at multiple levels:

  • Emotional: failure to conceive or to achieve a healthy pregnancy is emotionally detrimental and leads to post-traumatic stress disorder (PTSD). We can help you prevent such a predicament.
  • Interpersonal: guilt feelings and feelings of incompetence may cause serious emotional problems in couples. You need to be at peace with yourself as well as your partner. We can help guide you to a more peaceful inner space, which in turn should assist you to achieve your goals.  Knowing more about your diagnosis and making specific changes with a science-based plan will help!
  • Serious financial loss: costly and time-consuming office visits, expensive medications, and procedures can raise the cost of fertility treatments to unimaginable levels. The average IVF procedure costs $5,000 to $25,000, depending on which state you live in and the quality of the fertility clinic. On top of this cost, one must pay for expensive medications, additional procedures not covered by insurance, and suffer physical and emotional stress. Couples experiencing fertility problems might spend on average $75,000 to $100,000; the sad part is that almost half of them have nothing to show for it except for many unanswered questions, emotional pain, resentment, mistrust, and disillusionment. Depending on which of our three categories you belong to, you might be one of them. I hope not, so I can help you avoid this predicament. If you were unfortunate to have experienced the pain, I can still help you not only stop hurting yourself but, stop wasting your valuable money.
  • The average rate of success across all ages is 25% in western wealthy countries (USA, Canada, and Europe). This means it will take three to four embryo transfers to achieve one pregnancy but not necessarily to have a baby. IVF pregnancies are of the highest risk for fetal loss and pregnancy complications. Patients who have the complete in-person evaluation and are following our personalized protocols succeed to get pregnant 8 out of 10 times. What is equally, if not more important is the fact that our protocols reduce the rate of miscarriage and fetal loss by more than 80%. 
  • Spending $3,500 (limited virtual) or $5,500 (full in-person assessment) for a complete assessment might look like a lot of money but, it pales in comparison to all failed fertility treatments costing tens of thousands of dollars.

  • If you are only interested in understanding the reasons that kept you so far from realizing your dream, despite the fact that you have been treated by other specialists, you can sign up for a very affordable “expert record review” service. We will review all your medical records relating to your fertility journey and give you our expert opinion regarding possible medical conditions that might have not been detected, or available treatments that might have not been used in your case. We will do our best to extract as much information as possible from your available records.
  • This website is designed to provide you with information that can help you, your partner and your primary obstetrician and treating doctor advance and enhance your fertility goals.  Below you are being given an opportunity to self-select into your fertility difficulty category.  By choosing to learn more you understand that you are not becoming a patient of Dr. Kofinas.  In some circumstances, you may want to pursue a detailed consultation with Dr. Kofinas, the options are described in more detail below.  But, by proceeding with this self-designation and education, you as the consumer of this information, hereby expressly understand that you are not becoming a patient of Dr. Kofinas, and at this time are not receiving treatment from Dr. Kofinas.
In order to continue, you must acknowledge that you agree and understand the Benefits and Cost of Requesting an Online Consultation statement.*

If you choose to undertake a consultation with Dr. Kofinas, there are two choices: (1) visit one of our NYS-based offices and become a patient regardless of which state you currently live, or (2) request an online-only consultation virtual visit. Let me explain to you the differences between these two choices.

  1. Expert record review: for patients who seek only to understand what has been preventing them from conceiving or having a successful pregnancy. This assessment will be strictly based on the information provided to Dr. Kofinas by the records you submit. The cost for this expert record review is $500. If you choose this service, you may discuss our consultation report with your current fertility/MFM specialist or you might decide to select a full virtual or physical consultation with Dr. Kofinas and his associates, as presented below in choice#2 and choice#3. If you decide to proceed with a full consultation in virtual or physical form as described in choice#2 or choice#3, we will refund you the $500 after you have signed up for the next level of service. You must submit via email all your pregnancy and/or fertility treatment-related records to Dr. Kofinas. These will include all blood tests you and your partner/husband underwent, all the operative surgical reports you have, and all prior consultations/expert opinions. If you suffered one or more miscarriages, provide any testing done on the products of conception in all failed pregnancies. Dr. Kofinas might request more records from you if he perceives that you might have omitted one or more valuable test results due to misunderstanding. His review will explain clearly to you all possible reasons preventing you from getting pregnant, as evidenced by your records, and provide you with specific recommendations that could help your local fertility/MFM doctor expand the evaluation to identify more issues that might have been missed. If there are specific conditions identified and for which you have not been treated, you will receive specific recommendations for your doctor to consider if you attempt a new pregnancy. 

  2. In-person visit to one of our offices: Our offices are located in Manhattan or Garden City Long Island, New York.  The office is “out of network” and therefore the patient is 100% responsible for the costs of the complete evaluation.  Payment arrangements will be made so that payment will be collected during the first office visit.  Should you choose this option you will need to visit either office IN PERSON.  A detailed health history will be taken and a full fertility workup will be performed.  Once your evaluation is completed we will make recommendations and create a personalized protocol for future treatment.  At the completion of the consultation a bill will be prepared, with the diagnostic and procedure codes, which you can then submit to your commercial health insurance, so that you may seek reimbursement.  Depending on your insurance plan, you might get reimbursed anywhere from 40-100% of your expenses. This will happen only if you have out-of-network benefits including any deductible and coinsurance. The payment for the in-person visit does not include any of the lab tests. Some of the tests are covered by insurance and some are not, depending on your plan. At the completion of your evaluation, we will provide you with a complete report detailing our findings and will create a customized personal protocol to help you have a healthy pregnancy. If you choose to come to the office for an in-person visit, call us at (516) 832-0300 for a detailed description and to answer all your questions. We want to be sure that you are fully informed about the cost and to help you make an informed decision. 

  3. Virtual visit: If you choose to undergo a virtual consultation, then your evaluation will be limited to a thorough clinical history and a review of any relevant medical records, combined with a face-to-face discussion with Dr. Kofinas, which will take place using a HIPAA compliant virtual platform.  Suggestions may be made for further and optional comprehensive testing which may include evaluation for gene variations/polymorphisms that may be contributing to infertility and pregnancy loss. Some of these optional tests are not covered by health insurance plans and you will be responsible for this cost. We might also recommend additional tests that can be performed by any of the national medical laboratories that accept your insurance (Quest, Labcorp). At the completion of the evaluation, we will provide you with an expert opinion report detailing all the conditions we have identified that could prevent you from realizing your dream. We will also provide recommendations to your doctor for further testing as needed and for the best way to treat you, so you can have a successful pregnancy. We will be available for a brief telephone talk with your local doctor to answer any questions by your doctor after he/she reviews our recommendations.

What you will not have with a virtual visit, is the high-level, high-definition, ultrasound, and Doppler examinations of your reproductive organs (two such visits), that could only be performed by our clinical team in one of our New York offices. Before you proceed with a virtual visit, please, read carefully the information provided by selecting the proper link below:

I know all too well what you may be experiencing right now. You see, I have been helping patients like you all my professional life. You have tried to conceive naturally, and it didn’t work, or you have seen a fertility specialist and tried IVF and it failed repeatedly, or you are getting pregnant naturally or by means of IVF, but you’ve experienced recurrent miscarriages. All these problems appear very different, but they all share various degrees of the same underlying deficiencies in the two most important systems that make or break a pregnancy. 

The immune system and the coagulation (blood clotting) system are the two most basic and vital for a successful pregnancy. A clear understanding of any disturbances in these two systems is extremely important in correcting the imbalances and helping you achieve motherhood. Dr. Kofinas is among the most experienced reproductive specialist on these matters, and he has worked successfully with tens of thousands of patients like you in the last 37 years. This is your best chance to start your journey to motherhood the right way; trust us and move on!

HIPPA Notice of Privacy Practices*

Notice of Privacy Practices

THIS NOTICE OF PRIVACY PRACTICES (“NOTICE”) DESCRIBES HOW WE MAY USE OR DISCLOSE YOUR HEALTH INFORMATION AND HOW YOU CAN GET ACCESS TO SUCH INFORMATION. PLEASE READ IT CAREFULLY.

Your “health information,” for purposes of this Notice is generally any information that identifies you and is created, received, maintained or transmitted by us in the course of providing health care items or services to you (referred to as “health information” in this Notice).

We are required by the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) and other applicable laws to maintain the privacy of your health information, to provide individuals with this Notice of our legal duties and privacy practices with respect to such information, and to abide by the terms of this Notice. We are also required by law to notify affected individuals following a breach of their unsecured health information.

USES AND DISCLOSURES OF INFORMATION WITHOUT YOUR AUTHORIZATION

The most common reasons why we use or disclose your health information are for consultation, payment or health care operations. Examples of how we use or disclose your health information for consultation purposes are: setting up an appointment for you; testing or examining you; making recommendations for treatment protocols; referring you for additional or outside testing; or getting copies of your health information from another professional that you may have seen before us. Examples of how we use or disclose your health information for payment purposes are: asking you about your health care plans, or other sources of payment; and preparing bills for you to submit for reimbursement. “Health care operations” mean those administrative and managerial functions that we must carry out in order to run our office. Examples of how we use or disclose your health information for health care operations are: financial or billing audits; internal quality assurance; personnel decisions; defense of legal matters; business planning; and outside storage of our records.

OTHER DISCLOSURES AND USES WE MAY MAKE WITHOUT YOUR AUTHORIZATION OR CONSENT

In some limited situations, the law allows or requires us to use or disclose your health information without your consent or authorization. Not all of these situations will apply to us; some may never come up at our office at all. Such uses or disclosures are:

  • When a state or federal law mandates that certain health information be reported for a specific purpose;
  • For public health purposes, such as contagious disease reporting, investigation or surveillance; and notices to and from the federal Food and Drug Administration regarding drugs or medical devices;
  • Disclosures to governmental authorities about victims of suspected abuse, neglect or domestic violence;
  • Uses and disclosures for health oversight activities, such as for the licensing of doctors; for audits by Medicare or Medicaid; or for investigation of possible violations of health care laws;
  • Disclosures for judicial and administrative proceedings, such as in response to subpoenas or orders of courts or administrative agencies;
  • Disclosures for law enforcement purposes, such as to provide information about someone who is or is suspected to be a victim of a crime; to provide information about a crime at our office; or to report a crime that happened somewhere else;
  • Disclosure to a medical examiner to identify a dead person or to determine the cause of death; or to funeral directors to aid in burial; or to organizations that handle organ or tissue donations;
  • Uses or disclosures for health related research;
  • Uses and disclosures to prevent a serious threat to health or safety;
  • Uses or disclosures for specialized government functions, such as for the protection of the president or high ranking government officials; for lawful national intelligence activities; for military purposes; or for the evaluation and health of members of the foreign service;
  • Disclosures of de-identified information;
  • Disclosures relating to worker’s compensation programs;
  • Disclosures of a “limited data set” for research, public health, or health care operations;
  • Incidental disclosures that are an unavoidable by-product of permitted uses or disclosures;
  • Disclosures to “business associates” and their subcontractors who perform health care operations for us and who commit to respect the privacy of your health information in accordance with HIPAA;

Unless you object, we will also share relevant information about your care with any of your personal representatives who are helping you with your eye care. Upon your death, we may disclose to your family members or to other persons who were involved in your care or payment for health care prior to your death (such as your personal representative) health information relevant to their involvement in your care unless doing so is inconsistent with your preferences as expressed to us prior to your death.

SPECIFIC USES AND DISCLOSURES OF INFORMATION REQUIRING YOUR AUTHORIZATION

The following are some specific uses and disclosures we may not make of your health information without your authorization:

Marketing activities. We must obtain your authorization prior to using or disclosing any of your health information for marketing purposes unless such marketing communications take the form of face-to-face communications we may make with individuals or promotional gifts of nominal value that we may provide. If such marketing involves financial payment to us from a third party your authorization must also include consent to such payment.

Sale of health information. We do not currently sell or plan to sell your health information and we must seek your authorization prior to doing so.

Psychotherapy notes. Although we do not create or maintain psychotherapy notes on our patients, we are required to notify you that we generally must obtain your authorization prior to using or disclosing any such notes.

YOUR RIGHTS TO PROVIDE AN AUTHORIZATION FOR OTHER USES AND DISCLOSURES

  • Other uses and disclosures of your health information that are not described in this Notice will be made only with your written authorization
  • You may give us written authorization permitting us to use your health information or to disclose it to anyone for any purpose.
  • We will obtain your written authorization for uses and disclosures of your health information that are not identified in this Notice or are not otherwise permitted by applicable law.
  • We must agree to your request to restrict disclosure of your health information to a health plan if the disclosure is for the purpose of carrying out payment or health care operations and is not otherwise required by law and such information pertains solely to a health care item or service for which you have paid in full (or for which another person other than the health plan has paid in full on your behalf).

Any authorization you provide to us regarding the use and disclosure of your health information may be revoked by you in writing at any time. After you revoke your authorization, we will no longer use or disclose your health information for the reasons described in the authorization. However, we are generally unable to retract any disclosures that we may have already made with your authorization. We may also be required to disclose health information as necessary for purposes of payment for services received by you prior to the date you revoked your authorization.

YOUR INDIVIDUAL RIGHTS

You have many rights concerning the confidentiality of your health information. You have the right:

  • To request restrictions on the health information we may use and disclose for treatment, payment and health care operations. We are not required to agree to these requests. To request restrictions, please send a written request to us at the address below.
  • To receive confidential communications of health information about you in any manner other than described in our authorization request form. You must make such requests in writing to the address below. However, we reserve the right to determine if we will be able to continue your treatment under such restrictive authorizations.
  • To inspect or copy your health information. You must make such requests in writing to the address below. If you request a copy of your health information we may charge you a fee for the cost of copying, mailing or other supplies. In certain circumstances we may deny your request to inspect or copy your health information, subject to applicable law.
  • To amend health information. If you feel that health information we have about you is incorrect or incomplete, you may ask us to amend the information. To request an amendment, you must write to us at the address below. You must also give us a reason to support your request. We may deny your request to amend your health information if it is not in writing or does not provide a reason to support your request. We may also deny your request if the health information:
  • Was not created by us, unless the person that created the information is no longer available to make the amendment,
  • Is not part of the health information kept by or for us,
  • Is not part of the information you would be permitted to inspect or copy, or
  • Is accurate and complete.
  • To receive an accounting of disclosures of your health information. You must make such requests in writing to the address below. Not all health information is subject to this request. Your request must state a time period for the information you would like to receive, no longer than 6 years prior to the date of your request. Your request must state how you would like to receive the report (paper, electronically).
  • To designate another party to receive your health information. If your request for access of your health information directs us to transmit a copy of the health information directly to another person the request must be made by you in writing to the address below and must clearly identify the designated recipient and where to send the copy of the health information.

LEGAL DISCLAIMER AND INFORMED CONSENT

You are agreeing to have a telemedicine consultation. Telemedicine is the practice of medicine using electronic communication and technology.  Telemedicine consultation services are provided by Alexander Kofinas, M.D. or an associate of Kofinas Perinatal, P.C., all of whom are licensed to practice medicine in the State of New York.  If you avail yourself of these virtual consultation services, you are expressly acknowledging and understanding that you are not becoming a patient of Dr. Kofinas or his practice, but seeking a consult and set of recommendations through the virtual platform, that you will then discuss with your primary treating obstetrician.  The providers, in exercising their professional judgment, reserve the right to deny consultation for any reason, including instances where the provision of care would be medically or ethically inappropriate.  Receiving these recommendations through a telemedicine consultation offers certain expected benefits and has certain potential risks. Expected benefits include easier and quicker access to medical consultation, and the ability to access consultation from many locations. (For example, you can initiate a remote consultation from your home rather than having to wait to schedule one). Potential risks include that the provider is not able to fully examine you, or provide hands on care and treatment, and they may not be able to fully access your medical records or condition.  You have other options for care. You can obtain care in a traditional in-person care setting, such as seeing your primary provider, asking for a referral to a specialist, or traveling to see Dr. Kofinas in person.  By agreeing to have a telemedicine consultation, you acknowledge that you have reviewed these benefits, risks, and alternatives, and you agree that you consent to a telemedicine consultation, knowing that you are being provided with a limited consultation and not a full evaluation and formation of a doctor-patient relationship. You have the right to withdraw your consent at any time by ending this telemedicine consultation session. You agree to receive emails and push notifications (if enabled) about your consultation, including the provider’s name and consultation time. The availability of receiving the services on an in-person basis or via telehealth, if available, from your primary care provider, treating specialist, or from another individual health care professional is understood and expressly waived.  You also acknowledge that the representations made herein and prior success with other patients, as reported and discussed on this website, is not a guarantee of future success. To proceed you must agree here:
In order to continue, you must acknowledge that you agree and understand the Legal Disclaimer and Informed Consent statement.*
How would you like to proceed?*
EXPERT REVIEW LEGAL DISCLAIMER AND INFORMED CONSENT:*

You are agreeing to have an expert record review.  Expert record review is the practice of medicine using electronic communication and technology.  Expert record review services are provided by Alexander Kofinas, M.D. or an associate of Kofinas Perinatal, P.C., all of whom are licensed to practice medicine in the State of New York.  If you avail yourself of these virtual consultation services, you are expressly acknowledging and understanding that you are not becoming a patient of Dr. Kofinas or his practice but seeking a consult and set of recommendations through the virtual platform, that you will then discuss with your primary treating obstetrician.  The providers, in exercising their professional judgment, reserve the right to deny consultation for any reason, including instances where the provision of care would be medically or ethically inappropriate.  Receiving these recommendations through expert record review offers certain expected benefits and has certain potential risks. Expected benefits include easier and quicker access to medical consultation, and the ability to access consultation from many locations. (For example, you can initiate a remote consultation from your home rather than having to wait to schedule one). Potential risks include that the provider is not able to fully examine you, or provide hands-on care and treatment, and they may not be able to fully access your medical records or condition.  You have other options for care. You can obtain care in a traditional in-person care setting, such as seeing your primary provider, asking for a referral to a specialist, or traveling to see Dr. Kofinas in person.  By agreeing to have an expert record review, you acknowledge that you have reviewed these benefits, risks, and alternatives, and you agree that you consent to an expert record review, knowing that you are being provided with limited consultation and not a full evaluation and formation of a doctor-patient relationship. You have the right to withdraw your consent at any time by terminating this expert record review session. You agree to receive emails and push notifications (if enabled) about your consultation, including the provider’s name and consultation time. The availability of receiving the services on an in-person basis or via telehealth, if available, from your primary care provider, treating specialist or another individual health care professional is understood and expressly waived.  You also acknowledge that the representations made herein and prior success with other patients, as reported and discussed on this website, is not a guarantee of future success.

To proceed you must agree here: 

If you prefer to schedule an in-person visit to one of our NY offices, please, call (516) 832-0300 to speak to one of our staff.
Thank you for taking the time to review our services. We wish you the best possible outcome in your journey to motherhood click here to explore our website some more.

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Patient Intake Disclaimer:
Thanks for taking the patient intake! This will help us better understand your health and how we can best support you. By completing the intake and clicking “Submit” you are consenting for Kofinas Perinatal to view your answers. Your answers in this intake are safe and secure and will not be shared with anyone outside of this platform. Your medical information is protected under federal and state law, including HIPAA. We do not treat patients differently because of age, race/ethnicity or disability. Check out our Privacy Practices (Notice to privacy practices pages) for more details.
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