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Living in Ca. with PacifiCare ins and tying to figure out if I should try preapproval for a LM HB or if I shuold wait until after and file a claim? Any experience or thoughts?<br><br>
TIA <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/orngbiggrin.gif" style="border:0px solid;" title="orange big grin">
 

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It's a trade off. If you seek pre-approval you can either get it, or get your account flagged that they're going to get a bill for something they're not going to cover. If you don't get pre-approval you won't know until it's all said and done whether or not they're going to cover it.<br><br>
That's in general terms. I don't know anything about your specific insurance plan. YMMV
 

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I would check your policy carefully. While in CA insurance companies MUST cover LMs (though only CNMs are usually in network), they don't have to cover HB. I've read that many Pacificare policies (especially group plans) actually state that it is not a covered benefit.<br><br>
I've heard of some people getting around it by billing it using global codes... Several insurance billers I have talked to mention to call it an out-of-hospital birth (not home birth) if you go either route.
 
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