Treatment Outcome

Outcome Details
Last Name	First Name	DOB	PatientID	Case Number	Created Date	Service Code	Contract	Group Name		View Details

WIN Provider Portal Features

This portal provides services including :

• Search authorization history
• Request a prior authorization
• Submit medical/cycle history information
• Upload documents
• Enter Treatment Outcome
• Enter Prescription
• Search claims and remittance report

877.444.4946

Seeking a diagnosis of and/or confirmed ovarian hyperstimulation syndrome (OHSS)

Seeking a diagnosis of and/or confirmed ectopic pregnancy

Pregnant and bleeding

Seeking a diagnosis of and/or confirmed ovarian torsion

Fertility preservation related to a cancer diagnosis and/or iatrogenic cause of infertility. Requires impending plans for medical treatment, chemotherapy, radiation, and/or surgery that may lead to infertility

Any other medical condition deemed potentially harmful to the patient if not medically addressed.

None of the above apply.

Patient ID

First Name

Last Name

DOB

Contract

Patient Group ID

Patient Address

Authorization #

Authorized Service Date(From)

Authorized Service

Authorized Service Date(To)

Physician Full Name

Physician Group

Notification
Notification Date	Notifications	User Name

Document Types:

Choose Attachment:

First Name

Last Name

Member ID

Authorization #

From Date

To Date

Claim List Table
Member ID	First Name	Last Name	DOB	Authorization #	Claim #	Click To Select

Patient ID

First Name

Last Name

DOB

Authorized #

Authorized Service

Auth Requested Date

Related Service Codes
Service Code	Service Code Description	Base Service

As a valued member of WINFertility’s Provider Network we’d like to share with you the link to WINFertility’s Quarterly Provider Newsletter, offering the latest fertility news, tools and resources for your practice. Click Here

With the increased focus on diversity, equity and inclusion, clients expect WIN to make provider demographic information available to members. We ask that you share the requested information about your doctors to help our members select a provider. Any categories without a response will be indicated with “Not Available” on our member search. WIN appreciates your willingness to help us create great experiences for our shared members and patients.

If you would like this sent to a specific person in your practice who can provide this information, please provide their email id

Please provide the following information for each provider in your practice (At this time, your practice has provided this information for of providers)

Gender

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Is your practice LGBTQIA friendly

Yes No

Please provide the following information for your practice to enable WIN to automate future interaction and data exchange Name of EMR/s used in your practice

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Current Password

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WINFertility will be closed on Thursday, November 24 and November 25 in observance of the Thanksgiving holiday.

However, patients will have the support services of a Nurse Care Manager by calling the toll-free WINFertility number during this time.
Please try to get your authorization and prescription requests in early for any patients in cycle.

We are here to provide support to both you and your patients.

Have a safe Holiday.

Your feedback is important to us.

You will be receiving an email in the next day from Press Ganey that will request your assistance in completing a short 2 minute survey on behalf of WIN.
We ask that you complete this survey at your convenience.

Thank you!
Becky Waldman
SVP Clinical Services & Quality Assurance