Insurance Coverage and Billing

In some cases, a portion of the fee may be reimbursable by a private insurance company. Whether you can expect any reimbursement after the birth depends more upon your particular plan than the company itself (in other words, you can’t say with any certainty that Company X will cover your birth but company Y will not–it all depends on your specific plan).

We will conduct a Verification of Benefits, in order to ascertain whether or not you might expect partial or complete reimbursement. If it looks like you are likely to be reimbursed, we can submit a claim. Insurance claims can only be submitted after the birth, but the fee is due by 34 weeks. Therefore, the fee must be paid in full before you would get any reimbursement from your insurance company, and it is never guaranteed.

Our services are out-of-network, though occasionally you may request an in-network exception that is approved (you are responsible for negotiating this exception–we don’t have the woman hours to do so). In either case, your deductible would need to be lower than $3000 and your co-insurance would need to be favorable in order to justify submitting a claim. If no reimbursement is expected but you want to bill insurance in order to meet your deductible, or if you leave care before you’ve paid the full fee, we can provide a super bill to submit to your insurance on your own. As well, if you participate in a health sharing program, we will provide a super bill for you to submit to your insurance company.

We are not contracted by Medicaid or CHP+ at this time. (Medicaid/CHP+ contracts for Registered Midwives in Colorado is an important issue. If you would like to be active in changing this state law, please consider contacting your state representative and senator and telling them that you believe direct entry midwives should be covered provider types in Colorado.)