Health insurance woes!

[mainermoma]

I have been battling with our insurance company for over a month now. We are seeing a certified professional midwife (CPM) for care and would like her to deliver our baby at home. The insuance company says home births are fully covered when done by Certified Nurse Midwives (CNMs) not CPMs . In my state only CPMs do home births, CNMs must work out of a hosiptal. So I got a referral from my primary care physician to get full care from my CPM, but the referral was denied. Now I have to appeal. :dizzy:

Has anyone had any luck with convincing health insurance companies to cover home births? Any help or suggestions would be soooo helpful!

[Nosebite]

http://www.gentlebirth.org/archives/preApproval.html

This site is very helpful. It even includes a sample letter to your insurance company.

[alegna]

Do you have an HMO or PPO? If you have a PPO you should be able to get it covered at out of network rates. We got ours covered at 100% because I had a super midwife who read all of our insurance details and found a clause that said that surgery was covered 100%... well one of the global birth billing codes is under surgery :mischief

-Angela

[TurboClaudia]

does your insurance cover prenatal and postnatal visits by a licensed or certified provider? that may be the way to get them to pay without actually mentioning the homebirth part of it and distracting them by the word "homebirth". the treatment codes for prenatal and postnatal visits are the same regardless of type of provider.

~claudia