Coming back to share my experience to date. My son was born in January but due to a long, painful posterior-baby labor, we transferred so he was born in the hospital, not at home. I got a gap exception with my UHC PPO plan and boy am I glad I did! For 2010, I just had prenatal appointments. They handled those home visits differently than typical office visits so before the coinsurance kicked in, I had to met my deductible. If I hadn't gotten the gap exception, I would have gotten zero for the at home prenatal appointments in 2010. My reimbursement for the 2011 claims would have been significantly reduced without the gap exception as well. My midwife couldn't bill global due to the transfer.
My midwife had her biller bill for the time (about 36 hours) that she spent with us while I was in labor and that claim is still pending along with a claim for birth pool rental. There have been several claims denied because the codes weren't quite right and the biller is suppposed to rebill those. But they've processed my 2011 prenatal and postpartum appointments in network - well, I've had to call them a couple times because they processed it incorrectly the first time. According to my math, they are currently paying my midwife $1,800. Our balance with her is currently $2,400 (prepaid $2,000) so I hope they pay out at least $600 so we're all set with her. After all we have OB and hospital charges on top of the midwife fees.
So my advice is to jump through the hoops and get a gap exception! I really hoped I wouldn't have to transfer but it happened.
Also I was told (indirectly) by someone who works for UHC that asking for a supervisor tends to get things done because the number of transfers to a supervisor goes onto the record of that employee and is considered indicative of their work performance.