For our clients that have insurance we provide billing services through STM Billing. You can find more information about them by visiting their Facebook page at STM Billing. Below you will find some details about our insurance billing services or for complete details come in for a New Client Interview or one of our monthly open houses.
Insurance Billing for your Midwifery Care
General Information about Health Insurance
Selah Midwifery Center is not contracted with any health insurance plans
There is almost always some level of coverage for out-of-hospital midwifery care under you out-of-network maternity benefits
Insurance plans typically have a deductible and a co-payment that the client is responsible for paying.
There is a separate deductible and co-payment for mom and baby.
We will bill your insurance for your newborn care, newborn must be added to your policy according to the contract time allowance that you have with your insurance carrier.
The State of Idaho does not license freestanding birth centers. Insurance plans will often not cover the facility fees for unlicensed facilities. Insurance plans also will typically not reimburse the homebirth fee.
Your insurance plan determines the amount that the company will pay for your care. Sometimes the amount that your insurance plan is willing to pay (the allowable amount) is significantly less than the amount that is billed for your care.
Your co-pay is based on the allowable amount determined by your insurance plan
Your estimated out-of-pocket expense is based on Global Maternity charges, your deductible, your coinsurance, the Facility Fee or Homebirth Fee.
For instance, you have an insurance plan that has a $500 deductible and then pays 70% after the deductible has been met.
Your health care provider bills your insurance company $5,000* for the care they provide.
Your insurance plan determines that the allowable amount is $2,000.
You pay the $500 to meet your deductible.
Your insurance company then pays 70% of the remaining $1,500, which is $1,050.
You owe your provider $3950.*
Your insurance plan will not release allowable amounts for out-of-network providers prior to the service being rendered. This makes it difficult to estimate your out-of-pocket expenses.
*This is just an estimate and does not reflect the amount that Selah Midwifery Center will bill your insurance.
How our Billing Service Works
At the onset of care, you will complete a Financial Agreement with Selah Midwifery Center, you will also complete your intake and history through Client Care. Selah Midwifery Center uses STM Billing, a company dedicated to billing for midwifery care services, to bill out insurance claims. We at Selah Midwifery Center provide STM Billing with the services we provided and they bill the insurance companies. Your insurance cannot be billed until the birth of your baby or a transfer of care happens.
If your care is transferred to another provider and Selah Midwifery Center does not assist you in the birth of your baby, all services rendered will be itemized instead of billing the Global OB Care code. This means that if you transfer during labor and delivery we will bill your insurance for every hour of labor support, days at the birth center, prenatal visits and every other service provided that is normally part of the Global OB code. Please be aware that any special visits will be billed separately, as they are not a part of the Global OB Care.
Insurance Billing Fees
If you would like us to bill your insurance, you must have a Verification of Benefits done by STM Billing. This will be done by filling out the Client Registration form and emailing it to firstname.lastname@example.org, along with the documents required. This should be done before beginning care with Selah Midwifery Center. For more information, please contact the office at (208) 745-7571