Seeking opinions from momma experts on insurance

[tvantol]

I've been reading all about submitting claims and seeking preauthorization from insurance companies for HB on this thread and have gotten good information. We are now at week 36. I have a CNM and a lay midwife attending my birth. We have Blue Cross Blue Shield of NJ a PPO plan and live in MN. So the question...based on your experiences do I call now asking for preauthorization or wait and submit after the birth? I've heard mixed results here and need to make up my mind on a game plan soon.

[TSomm]

I'm in the same boat and curious to hear what others say. At this point, I'm thinking I'll wait until after. That way, when I have a successful birth I can show the insurance company the cost savings... ??

[MidwifeErika]

I think it depends.... does your insurance require pre-authorization before they will cover maternity benefits?

[Defenestrator]

I think if I were seeing a CNM, I would talk to them beforehand. The billing service I use will verify your benefits for you and apply for an in-network exception for $20. Check out midwifebilling.com.

That's one advantage to doing it ahead of time -- the possibility of getting the fee covered as in-network instead of out-of-network.

Good luck!

[tvantol]

Originally Posted by Defenestrator

I think if I were seeing a CNM, I would talk to them beforehand. The billing service I use will verify your benefits for you and apply for an in-network exception for $20. Check out midwifebilling.com.

Thank you! I actually called Midwife Billing and the woman was very nice and incredibly grateful to you for passing on her business on the discussion board. I will go this route. She has worked with my insurance company before.

[Mom2Blessings]

I have BCBS of Idaho and I am only 10 weeks pregnant but needed to know what my insurance thought about the whole birth being covered so my midwife called with all their "codes" to find out what was covered what wasn't (we had to sign a consent form for them to give her all our information regarding this) and it took a few days but we found out it was covered as out of network but I had to complete a prenatal screening that they required within a certian timeframe (so I called and completed it)...my midwife will bill them as soon as the baby is born to get back our money as fast as she can. I tried calling myself and it was a lot of mumbo jumbo they try and make it seem like they won't cover it but she told me to have the midwife call with the "billing codes" and my midwife hires a company to call and talk insurance buisness and get it taken care of...they also record all conversations so they can't later say they "never claimed to cover it"
I know that may not help you but I just thought I'd let you know what we had to do to get preauthorization for coverage out of network through my HB midwives just in case it would somehow

[white_queen_22]

We were pre-authorized and then the insurance tried to deny. I called and called and called.

Finally spoke with a "supervisor" and said something to the effect of - "This is my first baby and my health care provider submitted a claim in full for $2800 - TOTAL!. I am the oldest of eight children. Eight. And my mom took ten years off.

Now the average birth in Texas costs $11,000 so I have a question for you. In two years when I submit a claim from the birth of my second child would you like that bill to be $2800 or $11,000? It's completely up to you. Times 7 or 8 or 9 more children."

"Ummm....uh....I ah....Let me speak with our claims supervisor and see what we can do to expedite this payment"

*lol!!* That was three babies ago (currentl pregnant with #4) and we've had zero problems with our insurance paying the midwives since. Muhahahahaha

Angela <><

[pants]

Originally Posted by Defenestrator

The billing service I use will verify your benefits for you and apply for an in-network exception for $20. Check out midwifebilling.com.

Good luck!

Thank you for this!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! I'm looking into them for our next hbac.