OK - I'll tell you right now that this is not as straightforward as it seems.
This does *not* mean the homebirth parent is wrong - but just want to let you in on the reality of insurance billing so you all can understand what's going on. (Or what is probably going on - this is what I have seen with numerous midwifery practices).
The billing services that work with midwives will charge more than what the midwife charges the client. The amount charged to the client is sometimes called the 'deposit' on the birth fees. In this case it was $3600.
If the midwife uses a billing service, the billing service itemizes the midwife's fees and this is usually more than the 'deposit'. Sometimes it is double the 'deposit.' Let's say it was $5400. (Because that is not an unusual amount for the insurance to be billed.)
To the parents' knowledge - the midwife is billing their insurance company the same amount as they were charged, ($3600), and all payments from the insurance company should be refunded to the parents. There is no reason why parents should not assume this!
But in actuality, the insurance was billed more than what the parents paid.
Anyway - the process of refunding the parents gets confusing when the midwife billed insurance $5400 (this is what she is telling the insurance company it cost her to provide services), and 'charged' the parents $3600.
Insurance sometimes pays a percentage of the total fees charged - 60% or 80% - and the insurance company assumes that the policy holder (the parents) are paying the 20%-40% out of pocket.
If the insurance company agreed to pay 60% of the fees ($3240 is 60% of $5400), the parents are responsible for the other 40% = $2160. The insurance company in this case would 'refund' the midwife $3240, but the parents are expected to pay $2160. Or, at least, that is what the insurance company believes... because it agreed to pay 60% of the total fees charged.
The parents expect that $3240 is coming back to them. But in order to keep it kosher with the insurance company - the parent's refund is only $1440. ($3600-2160 = $1440)
It just gets confusing - and I saw very few midwives actually come clean with their clients and actually inform them of how much their insurance was billed. So parents believe that the midwife is holding on to their money (again, a rightful assumption!). And the midwife has to figure out a way to not commit insurance fraud by refunding too much money to the parents because if the insurance company pays a percentage of the total fees -the client is accountable for the difference.
Yeah - I don't know how this is legal - or ethical - I just know that this is how I've seen it done. And I'm not saying it's right!
I don't believe parents should be left in the dark about these practices. Unfortunately, they too often are.
If the midwife had charged insurance $3600 - this situation would be much more straightforward. My educated hunch is that much more was actually charged to your insurance company.
Sorry. This is a headache.