Richard M. Levin, MD., PSC. | Phone: 502-584-7787 | Fax: 502-589-3842 |

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Definitions and Qualifications

¢ Airport Transportation: For those coming in from Louisville International Airport, a courtesy van service is available to the Fairfield Inn and Suites. If you are a reversal patient you need to notify the hotel of your flight schedule ahead of time so they know to have the van there for you. You can also use this service to take you back to the airport so make sure to speak to the person at the front desk of the hotel the night prior to your departure to arrange for the appropriate time. For any other questions you have regarding the Fairfield Inn, please contact them directly by phone at 1-502-569-3553 or go to their web site at The Fairfield Inn and Suites

£ Second surgery: Dr. Levin's package price will allow for a second reversal surgery under certain circumstances. First and foremost is whether or not a second procedure would be likely to work or not. This conclusion is something that only Dr. Levin can make based on where your tube is blocked, how much tube you have left on the affected side and the “shape” the tube is in. Dr. Levin is willing to discuss these issues with you and will try to bend over backwards to allow for such a procedure but he will not operate in a circumstance that is not likely to have a positive outcome. Also you may not qualify if you have one open tube.

Dr. Levin will not charge you his profession fee but the fees of other parties must be paid for by you and you will be informed as to the exact amount before scheduling the procedure.

If you have concerns about this matter then please speak directly to Dr. Levin about this issue.

‡ Free Services: Dr. Levin provides various infertility services to his tubal reversal patients for free after he has done their surgery. Most hospital, laboratory or X-ray procedures done by Dr. Levin will have a negotiated fee with the provider which is roughly 20% of the normal charge and that fee is to be paid for by the patient. Any fertility medications, other medications, laboratory tests or frozen sperm needed by a patient must be obtained by the patient from a pharmacy, laboratory, sperm bank or other facility if such needs arise and any costs involved for such is the full responsibility of the patient.

Services not performed by Dr. Levin are the full responisibility of the patient. There are perhaps other things not listed here that are not things that Dr. Levin will provide as a free services and you should ask about specific things that you wish to know about to find out if Dr. Levin will or will not cover such services. Please do not assume that Dr. Levin can or will cover anything and everything that you might want to have done. These services are provided by Dr. Levin to help you get pregnant and are done as a good will gesture and do not convey any monetary value to you as a patient.

€ What's not covered: Dr. Levin's package price is intended to cover everything needed for 98-99% of all reversal procedures. There are occasional patients who have unusual health issues going on and we cannot contemplate the infinite possibilities that might arise. Therefore if you have something out of the normal relm you may receive a bill for such services from either the hospital and/or another doctor whose services were needed to help take care of you. If you have concerns about this matter then please speak directly to Dr. Levin about this issue.

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One Medical Center Plaza | 225 Abraham Flexner Way | Suite 501 | Louisville KY 40202