Hi there. I was not the original poster, but we've been through A LOT with BCBS PPO MA and I replied to the post a while back. After a 1.5 year long appeals process, I was told by the patient advocate that our claim is going through (after three denials), but it is important to note that our birth was before an October 2009 policy change where it is now written into the policy that homebirths are not covered at all. We haven't seen the money yet, but are assured the process is taking place.
So, for the specific BCBS PPO MA plan, I think it would be very hard to bill for a homebirth now. It was difficult before, but previously they sort of sometimes claimed that homebirth was covered if you used a CNM which of course there are none that are able to perform homebirths in MA. You then had to make the case (which we finally successfully did) that if homebirths are covered, but there are no CNM able to provide the service, they are obligated to cover an alternative. We did not have to go to small claims court, but that was our next step.
Thus, I think the only way you could get a homebirth covered with BCBS PPO MA is to challenge the actual policy.
Or, one strategy that I have heard used is to get the cost covered not by submitting the big fee for the birth, but my submitting one or two test claims early in the pregnancy for prenatal visits. They will often cover small charges by a CPM because it is not worth it for them to deny it and it just slips through the cracks. Once they approve one or two, wait until the end of the pregnancy or after the birth and try to recoup the expenses via submission of prenatal and postnatal care claims rather than through one big birth fee. Some do the submit all at once in the end, or they trickle the submissions in hoping that no one notices. If they have approved the initial test claims, if they later try to claim they do not cover such care with CPM, you can point out that they have already approved some. We also contacted previous families that they had covered (found on this board) and used that to demonstrate an inconsistent policy. This gets around the policy that they do not cover homebirths because it is not a homebirth they are paying for - it is prenatal and postnatal care. A good midwife billing service should be able to help you with this. We initially used a very very poor one that was extremely inept. But a good one can really help navigate this for you.