Help!!! Insurance billing my midwife!

[mammamouse]

OK- we had a lovely homebirth of Robby March 15. My insurance even agreed to pay the out of network PPO portion. So we paid Robin (the midwife) I think $900 which was the estimated portion we would need to pay out of pocket (she said she billed $2300 for a birth), and she was going to bill Cigna for the rest. OK? OK.

I got a check in the mail today saying Cigna had been billed $2600 for the birth, our responsibility was $780, and they cut US a check for the remaining $1820 and it was our responsibility to pay the provider of services.


Problem- I haven't heard from Robin since my 4 week checkup, and she told me then her family would be moving to Maine in June. So she got partially paid for a birth and moved and I have NO idea how to find her to straighten this out and see what I need to do to pay her for the birth.

How do I find my midwife? Help?

[kama'aina mama]

If she put in a change of address with the post office (most people do, don't they?) they will forward mail to her new address for a year. I wouldn't mail the check yet, but mail a note saying that you need to pay her and have the insurance money but you need to know where to send it. It might take a few weeks to get to her, but it should work. Good luck. I know how something like that can gnaw at you! It took us over a year to get our Ins to pay for a procedure our midwife sent us to a local OB for and the whole time it bothered me that they hadn't been paid.

[Arduinna]

I would try to contact some of the other homebirth midwives in the area. I know ours keep in touch with each other. They might have her forwarding address if you can't find her any other way.

[J&G's mom]

Those are both great ideas on how to contact her.
I just wanted to ask you how easy it was to get Cigna to pay? We have Cigna and planning a homebirth in Dec. Everytime I have called they haven't said yes but they haven't said no either.
Was your midwife a CNM, CPM, LM? And they ended up paying 80 percent for "out of network"?
Your experience with them would be really helpful. TIA for any info.
J&G's mom

[mammamouse]

Our Cigna plan said they would pay birth center births out of network as an 80/20 split. My midwife was a Prof. Midwife and billed as a birth center. She said Cigna was one of the easier companies to get payments from.

I made a few calls this afternoon and found the midwife she referred her clients to, so I'll call her tomorrow and see where things go.

[DirtyHippie]

I live in Maine. Will she be practicing here? If so I may be able to find her for you.

[SpiralWoman]

insurance question

if it's not too personal, did Cigna know you were birthing @ home or did they really think you were going to a birth center & would that have mattered? Like did you call them & say " I am having a home birth and..." or did your midwife just already know what to do? I have Cigna & I am very excited that I might get coverage for a home birth! We have been planning to pay out of pocket! Thanks for any info you would be willing to give, Maria

[mammamouse]

I never talked to Cigna personally. I've had 2 birth center births and one home birth, and something I learned early on - Let the midwives/office staff talk to the insurance company. They know what questions to ask the insurance company, and how to phrase things to get it covered if coverage is a possibility. IF I were to have called and siad "would you cover my homebirth" they most likely would have flipped out. After one of my birth center births we had a billing issue (not with Cigna at that time) , and even though my policy clearly stated it covered birth centers the claims person I spoke with not only didnt' know that an out of hospital birth would be covered, she didn't know that it was "legal" to do such a thing! : If you midwife doesn't deal with biling I'd at least ask her what questions to ask of hte insurance company.

[SpiralWoman]

thanks Monica, that is super helpful advice!