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Discussion Starter · #1 ·
Has anyone in WA state had DSHS (I have an open coupon, so no insurance company to go through) cover a VBAC Homebirth? My midwife says that she can't bill the birth (can bill prenatal and postpartum though) because DSHS does not cover HBAC. Anyone gotten them to pay? Or had them pay it and then realize it was a VBAC and make your MW pay them back? Any info would help. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"><br>
Thanks<br>
Allison
 

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I'm just bumping this for you because I have a friend who would love the same info.<br><br>
DSHS covers homebirth, I don't see why HBAC should be different, the bill should look the same right? I don't think our providers are passing along a whole bunch of medical background info (um, scary if they do, but would explain the deliberate non-collection of a few items by my midwife), just procedural info right?
 

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Discussion Starter · #3 ·
I have been researching a bit and looking online at the WAC's. Well to qualify for a HB you need to meet certain criteria. And according to the DSHS website and the WAC (don't remember which one but can prob find it again) having had a previous c/s excludes you from the HB criteria. And when a provider signs their DSHS provider contract it states in there that they will only do things approved by DSHS. So since the WAC states that HBAC is not a covered procedure then DSHS will not cover it. Someone with more knowledge about WAC's and DSHS please feel free to correct me. I am by no means an expert.<br>
Allison
 

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As a previous homebirth midwife medical biller- I can answer the question about DSHS knowing it is a VBAC. There is a certain code used for a primip mama (first time) vaginal birth, multip mama vaginal birth, or VBAC, or c-section. These are diagnosis codes. There is ALWAYS a diagnosis code associated with the procedure code. In this way the insurance companies try to make sure that correct procedures are billed for the diagnosis- to lessen medical insurance fraud. Occasionally an insurance company, especially state insurance will audit a practicioners medical files to be sure that the claims filed match the recorded records in the patient's chart. So, if you are having a VBAC, that will be noted in your file- and if it is not on the diagnosis on the form, that is fraud. sorry.
 
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