For those who have BCBS and got any reimbursement...

[naturallyspeaking]

Did you have HMO or PPO? How early (before baby was born or due date) did you submit the reimbursement paper work? How much did insurance pay you back?
Who or what department did you talk to to negotiate this?
We have BCBS HMO in FL (my dh is city employee) and after a few weeks of waiting an answer "how much" they will pay us back, we got an answer of "denied". I don't even know what they are denying? or Why??
I'm due around in 5 weeks now. What/who do I need to do to convince or get paid at least something?? I feel robbed of my privilege of health care benefit even though having/paying for insurance and not get paid at all!
Another stress (to do list) before baby comes...

[StephM76]

I have BCBS PPO and they covered all but $600

[stormborn]

PPO...they covered basically everything except the Dr's actual 'housecall' fee ($500 cash). I didn't tell them it was to be a homebirth or anything; just submitted all the labs and prenatals.

[naturallyspeaking]

What do you mean by dr's housecall fee? Did you have homebirth or used a nurse mw at a hospital at birth?? If you didn't tell them about hb although you did, how did you phrase it when you submitted? I hadn't thought about that (not telling hb) but then wouldn't they ask "which hospital" you are/did use?? Thank you.

Originally Posted by stormborn

PPO...they covered basically everything except the Dr's actual 'housecall' fee ($500 cash). I didn't tell them it was to be a homebirth or anything; just submitted all the labs and prenatals.

[stormborn]

Originally Posted by naturallyspeaking

What do you mean by dr's housecall fee? Did you have homebirth or used a nurse mw at a hospital at birth?? If you didn't tell them about hb although you did, how did you phrase it when you submitted? I hadn't thought about that (not telling hb) but then wouldn't they ask "which hospital" you are/did use?? Thank you.

I just submitted all if the prenatal visits as usual and didn't mention it basically. The doc already told me that his fee for the birth was not covered by BCBS so I didn't even attempt to collect on that. It was a birth at home with an obgyn (how cool is he?!?) attending and the $500 was the total fee for the actual delivery part. I didn't intend to hide it from the ins co; it just didn't seem necessary to tell them since I knew it wasn't covered. Which is a rant post in itself; think of how much money I saved them by not going to the hospital.
Tell me if I'm not making any sense...'tis late here and I have 2 wild children distracting me.

[wildnewmamma]

:

I just switched to BCBS ppo, partially because my mw said that they have reimbursed clients before...I think one thing that saves us is that we live in a "medically underserved area"- a nurse mw would be covered, but the only nurse mw delivers in the hospital only. So I guess we will see when it comes time to submit the paperwork, I was told we have to submit after the baby is born. It will be interesting to see how this works out for folks, so if you don't mind update the thread with how this works out for you. I know each state, and sometimes even depending on who you work for is different, so it's kind of hard to compare, but it at least gives you an idea what you might be up against.

[Jilian]

I have BCBS of FL PPO and have spent a lot of time on the phone with them finding out what they cover. They have sworn to me that they cover just as much for a irth center/HB that they cover for a hospital birth. My HB MW has had mixed experiences with them and says they cover what they deem a "reasonable fee" for the MWs services. She has seen insurance companies set their "Reasonable fee" as low as $1500 for birth and prenatal care But as far as we know they should cover 90% of the cost because my plan makes me pay 10% (up to the first $1,000 out of pocket). We'll see!

[lthw]

I haven't had a HB yet but since we just switched to BCBS I asked them if HB was covered and was told yes, 100% since it's treated as outpatient care. Don't know what will come to pass, but that's what I was told!

[My*Scorpio]

I started the process by calling and asking for a referral for a MW. They didn't have any in my state. They tried to tell me I'd have to drive 1.5 hours each way to see a CNM in a different state. I complained to HR, and they ended up making an exception for me.

They have been reimbursing the prenatal visits. We will see if there are any issues with the birth, but I doubt it. I have a preapproval letter for my CPM.

[JamieBrewHa]

We have BCBS of MN... PPO. We were told they would cover prenatal care at normal percentages but nothing of the birth if it's not in a hospital.

Our midwife submitted one prenatal.... we got $200 (our deductible had already been met for that year). Then she will sbumit everything else after the birth. We are hoping and praying we get a decent amount back.

[naturallyspeaking]

Looks like all of you have PPO. Has anyone with HMO got paid any reimbursement??

[octobermoon]

i want to know too as we have HMO.

[Eresh]

I have BCBS PPO and they covered 100% since my MW was in network (though apparently BCBS is moving them to out of network in March). BCBS wouldn't cover the $600 for the birth assistant though even though they said on the phone beforehand that they would. I didn't fight them on it though I probably should have.

[peainthepod]

PPO and they covered every penny.