Insurance Requires Home Birth Midwife be a Nurse. Help?

[lactatinggirl]

Has anyone dealt with this situation? The midwife I plan on going with is a direct entry midwife and training to become a CPM. Neither of which require a nursing degree. I don't believe that any CNM's in the area do home births. Utah (my state) says that's legal, but the insurance says my policy states that the midwife has to be a nurse for them to cover it. Is there any way to work around this? If not, I'm still doing a home birth. It would just be much easier for us financially if we didn't have to worry about this. 

[just__angel]

You *might* have some luck filing an 'out of network provider' claim since there is no CNM in your area. Good luck mama

[LiLStar]

do you know of anyone else in your state with the same insurance who has home birthed with a dem, and whether they were successful in getting reimbursed? its worth asking around. check finding your tribe, and maybe any local AP groups, lll, ICAN, etc. they might just cover it at an out of network rate. I personally would just cross my fingers, hope for the best, and go for it. have your midwife bill them after the birth and see what happens? (I wouldn't call the insurance ahead of time and ask, either. that just puts you on the radar as "oh, look, this person might submit a claim that we should probably deny"..or at least thats my superstition) then if they do flat out deny it without paying anything, i'd make a pest of myself and see if i can accomplish anything that way. Hey, I have a cousin who lives in Roy who homebirths!

[lactatinggirl]

Quote:

Originally Posted by LiLStar 

do you know of anyone else in your state with the same insurance who has home birthed with a dem, and whether they were successful in getting reimbursed? its worth asking around. check finding your tribe, and maybe any local AP groups, lll, ICAN, etc. they might just cover it at an out of network rate. I personally would just cross my fingers, hope for the best, and go for it. have your midwife bill them after the birth and see what happens? (I wouldn't call the insurance ahead of time and ask, either. that just puts you on the radar as "oh, look, this person might submit a claim that we should probably deny"..or at least thats my superstition) then if they do flat out deny it without paying anything, i'd make a pest of myself and see if i can accomplish anything that way. Hey, I have a cousin who lives in Roy who homebirths!

Thanks I'll try asking around. I'm on the phone with them right now arguing, but if they still say no I might submit the claim after the birth anyway and argue it again. I'd just really like to get this taken care of before having a newborn if possible. 

What's your cousin's name? Maybe I know her?

[LiLStar]

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