Confused about midwife bill

[madis81]

We switched from an ob/gyn to a midwife I think at 32 weeks. We saw her 5 times, and instead of being charged the rate ($125.00 / per visit) that was in the handbook that she gave me at the first appt we were charged for "global ob care". Not only was the amount in the handbook different, but I also recieved an e-mail before our first visit and was told that they would pro-rate the cost. Our bill more then tripled! I questioned them on it and they said it was policy to charge global care if you have more then 4 visits and the price in the handbook was not clear on that so they took it out. Is this a normal practice? I feel so mislead. And I wish I could find that e-mail they sent me!

[BetsyS]

Did you use this midwife for delivery and postpartum services as well?

If so, I'd say this is pretty standard. I switched practices a little earlier than you--around 28 weeks. I was charged a global fee from that provider.

I'd already seen a different midwife until 28 weeks, but it was only 3 visits. They were all charged individually, but not until after I transferred, and they figured out that I wasn't coming back.

[nashvillemidwife]

Yes, the global billing policy is standard. The way they've handled the discrepancy with the handbook is not. It should have been made clear to you from the start and you should complain by telling them that while you now understand the global billing policy, it was deceptive and inappropriate for them not to explain that to you in the beginning. If the situation were reversed and it was the patient that was balking on the original payment agreement you can be sure it wouldn't sit well with them either.