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#61 of 72 Old 10-21-2011, 02:25 PM
 
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Originally Posted by IdentityCrisisMama View Post

FYI, Jenga, I have no idea how this is possible but CPMs in MD can bill insurance.  I'm not sure how that is possible but I know for a fact that it is.  I don't think this falls under the category of fraud -- maybe more like insurance providers and credentialing agencies being in such different fields.  Cuz, believe me if my insurance company could find any excuse to not pay for anything they certainly would!  

It's possible b/c they are care providers, have a provider number and use an out of state billing agency.  It's not illegal as far as I know.  My insurance at the time only covered legal CNM's, but the CPM was covered as an out of network provider at 80%.  We had a hiccup in the coverage b/c I failed to get pre-authorization for "home health."  But we argued that we had no idea that home birth was covered under "home health" instead of "maternity."  We won.
 

 


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#62 of 72 Old 10-21-2011, 02:54 PM - Thread Starter
 
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I think that may be a great argument to try with my insurance company if we ever decide to have a home birth and choose a CPM. 

 

My former midwive was out of network but our insurance company covers a LOT for maternity care. They cover my new midwife, I think I pay 25$ a day in hospital fees. 

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#63 of 72 Old 10-21-2011, 09:47 PM
 
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Originally Posted by Jaimee View Post

To me, the lapsed license is not a huge deal as I have used several CPM's that are not licensed in the state they are practicing in b/c it is not legal.   I realize that a CNM license is different since it is legal in all 50 states (as far as I know), but there are some reasons not to get licensed.  When you license yourself you agree to the terms of that state, which may prevent her from carrying oxygen and pitocin, etc.  While it doesn't exactly sound like this is the case for this particular midwife (as she seemed to have one, not have one, then get one again), I just wanted to point that out for others reading this thread and questioning mw's without licenses.  Also, the illegal billing portion... I personally am quite grateful that my illegal, un-state-licensed mw billed my insurance b/c we got most of my homebirth covered.  She used an out of state billing company.  I don't see this as a red flag either.

 

HOWEVER, all that being said, the way she treated you was inexcusable and I'm very glad that you found a provider you are happy with. 

 



I'm not passionately for mandatory midwifery licensing, and it's not required in my state. But if you're going to put yourself out there as a licensed provider and bill insurance, you dang well better BE a licensed provider, or it's fraud, and if the threadstarter feels strongly enough about not being part of someone violating the law (even if she's not the one doing it) that she won't go to a CPM, then a CNM who has let her license lapse in a state where unlicensed midwifery is illegal is being fraudulent not only with insurance, but with her clients. 

 

And if the insurance requires providers have a state license to bill, then billing them without a license while representing oneself as a licensed provider IS fraud. If the insurance does not require it, then it's not. 

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#64 of 72 Old 10-21-2011, 10:22 PM
 
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Oh goodness gracious!!!  How very unprofessional to drop you as a client because of a post she read on the Mothering boards.  It's ridiculous, it's damaging to you, and a sign of someone who lacks self perspective!
 

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Originally Posted by Jenga View Post

I have been urged to file a complaint with the board that licensed her.

I don't know if I'll do that yet, but we did find out that it wasn't ok to have a prenatal appointment with an assistant who was not specifically trained to do a medical exam without the midwife in the room. I haven't been seen by a practitioner in over a month now, and that makes me nervous. Mostly because I had early losses before and complications at the end of my first pregnancy.  Other midwives I have spoken to, other medical professionals and especially a nurse practitioner I am friend with (not OBs, yet.. as I haven't been able to see one if I end up having to use one for the rest of my pregnancy) have told me that what happened was not ok and also not my fault. 

 

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#65 of 72 Old 10-22-2011, 04:19 AM - Thread Starter
 
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Originally Posted by Viola View Post

Oh goodness gracious!!!  How very unprofessional to drop you as a client because of a post she read on the Mothering boards.  It's ridiculous, it's damaging to you, and a sign of someone who lacks self perspective! 

 



Oh that wasn't the only reason. It is very clear to me that she was nervous about what I'd find out after talking to people online. I found out that she had an expired ( or "just lapsed") license. I also talked to someone who had a nightmarish situation happen with my former midwife. That the midwife doesn't include her in the statistics on her webpage, either. Why not let her record speak for itself if she is an amazing provider? It wasn't even a death, but would have been a transfer post-delivery, according to the other poster, which happens sometimes and is understandable. I wonder what else she was withholding from her clients.

 

I think she didn't like that we started to ask questions and that I was getting advice from other people, she didn't like that I "didn't trust her" and the question of. "who is going to be the backup" was one she would never answer. I also think she waited until I paid her assistant to drop me, because she seemed to know I had posted online well before she dropped me. She said that she thought my posts could hurt her reputation. Her "former client" posting here said that the midwife was going to sue me and so on and so on.  She'll be answering to the board of nursing and they don't have a leg to stand on when it comes to a libel or defamation suit and any lawyer would tell her that. Which is funny, since she told me she doesn't want to talk to me and wants me to talk to her lawyer. Where is the lawyer? I'd love to talk to him or her about the license. I could sue the bajeesus out of her for it. Luckily I'm not litigious. 

 

 

Also, I think she wanted me to terminate her. Then she wouldn't have been required to see me for 30 days after she dropped me or until I got another provider. She didn't do that either, though, after she dropped me. 

 

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#66 of 72 Old 10-24-2011, 06:45 PM
 
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My midwife ended up dropping me at 37.5 weeks.

 

 

 

 

Did she transfer your care or offer alternatives for care?

 

It is exactly this peer pressure environment with midwives that have had me contemplating a hospital birth. It is ridiculous and dangerous. Better a c/s than a hb with a midwife you can't trust. The worst part is, they have done it to themselves. No lab coat clad doctor could be the horrid witness many of them have been.

 

That being said there are great, caring, competent mw's out there - just getting harder to find them from among the hippy dippy 'wanna be a mw' types much love to you Jenga.


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#67 of 72 Old 10-24-2011, 07:15 PM - Thread Starter
 
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Originally Posted by Onemoreontheway View Post

My midwife ended up dropping me at 37.5 weeks.

 

 

 

 

Did she transfer your care or offer alternatives for care?

 

It is exactly this peer pressure environment with midwives that have had me contemplating a hospital birth. It is ridiculous and dangerous. Better a c/s than a hb with a midwife you can't trust. The worst part is, they have done it to themselves. No lab coat clad doctor could be the horrid witness many of them have been.

 

That being said there are great, caring, competent mw's out there - just getting harder to find them from among the hippy dippy 'wanna be a mw' types much love to you Jenga.

 

She had it arranged so her friend, a CPM would take over my care. But they can't practice legally here. She told me she made a call to another midwife who I had already spoken to and the other midwife wouldn't take me (I'm a VBAC patient and she doesn't do them). She told me to call a birth center who "did VBAC" but they don't, they haven't since 2004 in the birth center. She made no other suggestions. 
 

She was hoping I'd use the CPM, I think, since she had already worked something out. When I called her to ask for my records a second time, she seemed unaware that CPMs couldn't practice in our state, or at least shocked that I knew that and was bringing it up... but she doesn't seem to care about licenses and stuff like that. We'd have had to pay her friend, the CPM, something like 3500 dollars and we had just paid this midwife's assistant 700$ and had paid her a deposit of 500$. My husband seriously thought it was a scam, at that point, because we'd have to pay this CPM so much money for a few weeks and we'd never see the deposit back from the other midwife and we weren't sure if we'd see the assistant's fee either. We couldn't put down over 3k at that point for a new midwife anyway, even if we were going to ignore that the midwife she referred us to told me that there was a "slight chance" that we could face charges if we used her. I don't know if that's true, but that is what she told me. 

 

 

But anyway, she didn't make any other suggestions or try to help the second time I demanded my records over the phone. She didn't talk to me or have any communication at all until the e-mail she finally sent with my records. Then I heard nothing until I called her about the license issue and she screamed at me and refused to talk anymore - which I understand seeing as she just got caught in a bad situation. By law she was required to see me for 30 days or until I saw a new provider, I have been told, and she did not do that. She definitely abandoned me as a patient. I am lucky I could get in with someone else. 

 


She was supposed to be a licensed CNM. Not a wannabe at all. :(

 

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#68 of 72 Old 10-24-2011, 08:50 PM
 
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Wow, Jenga. *shakes head* I'm seriously sorry.

A CNM or CPM or even a DEM - initials don't matter. What makes her a wannabe is the sorry way she has handled this. :(

 

 

What are you going to do, and isn't your due date any day now?


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#69 of 72 Old 10-24-2011, 09:43 PM
 
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Mama,

I'm so very sorry this happened to you. My youngest was born at home with a wonderful midwife. It was such a beautiful thing, I can't imagine having a prenatal relationship with someone like your midwife. I'm not sure why she would be worried that what you posted would damage her reputation. It seems like her own actions are what's hurting her. If everything you're saying is true, please consider taking her to small claims court. You can collect up to $5,000 in small claims court. I'm not a litigious person at all. I've never sued, nor have I been sued. But if she did this, she needs to give you all or at least partial payment back ASAP! It does seem reasonable that she should get to keep some payment for services she did provide. But shame on her for holding your medical records for as long as she did. She should have given you a copy the day she "fired" you. She sounds extremely unprofessional and I'd bet you aren't the only client unhappy with her. Maybe it's all a blessing in disguise. I know you are about to be (if you aren't already) super tired and busy with a new baby but I strongly urge you to file complaints, speak to a lawyer (you don't need one for small claims court), etc. Even though it may not help you out at the moment, maybe it will keep this bad situation from happening to other families.

Good luck to you and your new baby!


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#70 of 72 Old 10-25-2011, 04:58 AM - Thread Starter
 
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Quote:
Originally Posted by Onemoreontheway View Post

Wow, Jenga. *shakes head* I'm seriously sorry.

A CNM or CPM or even a DEM - initials don't matter. What makes her a wannabe is the sorry way she has handled this. :(

 

 

What are you going to do, and isn't your due date any day now?



 

I got a new provider on my own, I had to go to the ER one night and was harassed about the situation by an OB. Patient advocates referred me to another CNM who works in a birth center in the hospital and I will deliver at the hospital.
 

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Mama,

I'm so very sorry this happened to you. My youngest was born at home with a wonderful midwife. It was such a beautiful thing, I can't imagine having a prenatal relationship with someone like your midwife. I'm not sure why she would be worried that what you posted would damage her reputation. It seems like her own actions are what's hurting her. If everything you're saying is true, please consider taking her to small claims court. You can collect up to $5,000 in small claims court. I'm not a litigious person at all. I've never sued, nor have I been sued. But if she did this, she needs to give you all or at least partial payment back ASAP! It does seem reasonable that she should get to keep some payment for services she did provide. But shame on her for holding your medical records for as long as she did. She should have given you a copy the day she "fired" you. She sounds extremely unprofessional and I'd bet you aren't the only client unhappy with her. Maybe it's all a blessing in disguise. I know you are about to be (if you aren't already) super tired and busy with a new baby but I strongly urge you to file complaints, speak to a lawyer (you don't need one for small claims court), etc. Even though it may not help you out at the moment, maybe it will keep this bad situation from happening to other families.

Good luck to you and your new baby!


I filed complaints with the board of nursing. I called everyone you can think of (ACNM, my insurance company, etc etc) and they all encouraged me to go to the board of nursing. 

I could see that it would be fair if she kept the 500$ deposit, but she wasn't licensed when she took me on as a patient. She let her license lapse, and I specifically asked her if she was a CNM because I knew that my insurance company would pay for it and that was what we were comfortable with. She also billed them when her license was lapsed, and they found out after I told them, so they'll go after her for whatever they will go after her for. She had other clients using the same company, and they're going to go back and figure things out. 

She lied to me about the license. I never thought to look it up online or to not trust her. When I called her to talk about it, she screamed at me and told me I didn't know anything, that I thought I knew things from looking them up online and I didn't know as much as her. I told her she couldn't practice on a lapsed license and she told me she wasn't going to speak to me anymore. She just said I didn't know what I was talking about. Well, the board of nursing will decide if any of the other things she did were wrong, but this one was definitely wrong. You don't practice as a nurse if your license is not up to date, because it's illegal. 

 

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#71 of 72 Old 10-25-2011, 05:32 AM
 
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I'm so sorry you are going through this!  I had a midwife with my second birth. However, since we moved into the area, I'm thinking that for the third, given the atmosphere and some other things about hb generally, that we won't.

 

I agree that she should have to refund 100% of all monies paid as they were obtained under a fraudulent premise that she was licensed to provide care in your state.

 

Its funny -- I have experience dealing with a number of small businesses/single proprietors over the years.  I will say that 99% of the time, a small business that runs a sloppy office (as you describe your mw doing) is also a poor service provider.  If someone isn't organized and on top of things enough to schedule appointments appropriately, maintain correct records, etc., etc. they usually end up not being great at the job you actually pay them for.


I support homebirth that meets the qualifications set forth in the AAP's 2013 policy on homebirth.

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#72 of 72 Old 10-25-2011, 05:57 AM - Thread Starter
 
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Originally Posted by Buzzbuzz View Post

I'm so sorry you are going through this!  I had a midwife with my second birth. However, since we moved into the area, I'm thinking that for the third, given the atmosphere and some other things about hb generally, that we won't.

 

I agree that she should have to refund 100% of all monies paid as they were obtained under a fraudulent premise that she was licensed to provide care in your state.

 

Its funny -- I have experience dealing with a number of small businesses/single proprietors over the years.  I will say that 99% of the time, a small business that runs a sloppy office (as you describe your mw doing) is also a poor service provider.  If someone isn't organized and on top of things enough to schedule appointments appropriately, maintain correct records, etc., etc. they usually end up not being great at the job you actually pay them for.



The attitude here is really really unfortunate. There are so few CNMs who do homebirths. 

 

She was licensed before, and she is licensed now. But that won't help with the board of nursing when they see that she was seeing (a lot) of patients without a license. There's no reason to let a license lapse, there just isn't. I'm not talking about days, either, it was months. Especially considering the atmosphere here in the state, why would you want to risk it? The license gets renewed every year at the same time (the end of the month on your birth month)  so she had to have know it was up for renewal, it wasn't her first renewal cycle in this state anyway. It just seems like a lot of risk and possible legal problems for no reason.

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