Oh and if you want it, this is my appeal letter:
February 13, 2009
xxx including
xxx
P.O. Box xxx
Redmond, OR 97756
Dear Sir or Madam:
This letter is in response to the denial of coverage for the prenatal care, labor and delivery, and post partum care surrounding the birth of my daughter, Holly Pittman, on 12/23/08.
After having our first daughter in the hospital in February 2007, we were not satisfied with the care we received and were astounded by the cost of having a simple, non-complicated pregnancy and birth. When I became pregnant with Holly in March 2008, we searched for a better, less costly alternative. Due to the horrifying statistics of unnecessary interventions such as vacuum and forcep delivery, episiotomies, pitocin inductions, and especially that 1 in 4 women are given c-sections, we determined that the healthiest and most cost effective birth option was a homebirth with an attendant midwife.
During our midwife’s first visits, we were insured through xxx's Regence BlueCross Blue Shield plan. Knowing that she had been paid many times through BlueCross, we had little to worry about. Unbeknown to us, our provider would be changing half way through the pregnancy to a new provider. Our new in-house health insurance was supposed to be better and cheaper for everyone. Obviously that is not the case for us, with your recent denial to cover the cost of the birth of my daughter.
I am including a breakdown of the cost to deliver my first daughter in a hospital setting:
$3,515.78 Prenatal/Post partum care and delivery charges paid to midwife, xxx
$6,519.95 Bill from the hospital for Angela
$910.00 Paid to xxx, the anesthesiologist that performed the epidural
$3,100.35 Bill from the hospital for Lexus (new baby)
$1,187.94 Charges incurred for Dr. visits and shots for baby's first 6 weeks
_______________
$15,234.02 TOTAL
Clearly it is in the best interest of the company to keep costs low for health insurance. The cost for an OB/GYN to do the prenatal care, a hospital birth with attending physicians, and the following stay in the hospital, would have cost nearly five times the $4,100 that my midwife Marcene charged for the ENTIRE course of maternal care. I had complete prenatal care, labor and delivery support, post partum care for six weeks, as well as checkups for baby for six weeks.
Aside from the obvious point that it saves thousands of dollars, I'd also like to comment on the quality of service I received from my midwife. From my first appointment to my last at 6 weeks post partum, I felt a strong and loving connection with Marcene. She always made me feel completely comfortable and that she deeply cared for my baby and me. I never felt that with the quick 10 minute checkups at the clinic that I had with my first baby. Marcene was wonderfully knowledgeable and gave me a sense of empowerment throughout my labor, making me realize I am a woman and was made to do this. When baby was born, she was healthy, alert, and ready to nurse. I was able to hold baby for as long as I wanted and wasn't forced into doing anything I didn't want to do. There were no nightime blood draws for myself or my newborn, no IVs, no pills, etc.
I feel like I healed more quickly, bled less, and enjoyed my experience more because I chose to have a homebirth. I also believe the continued support, as well as the more enjoyable birthing experience has helped stave off post partum depression, which in itself can be another long-term costly medical liability.
The representative on the phone told me that home births are not covered. I urge you to ask why that is and to reconsider, for the numerous reasons stated above, as well as countless other benefits to having your baby at home.
Thank you for reconsidering coverage of the birth of my daughter.
Sincerely,
) and we have already prepaid my midwife and I am not going down without a fight to get my 70% OON or 80% regular network reimbursement!
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