Having an out of hospital birth can be a rewarding experience; however, getting covered by your insurance provider can be tricky. You need to know the right questions to ask and be proficient with Florida’s laws on the matter. That’s where we come in. Our first hand experience in home births and knowledge of medical billing gives us the necessary skills to assist you.
Trust us when we tell you, medical billing is really a full time job. Making sure your clients’ insurance company will cover your services is the smart thing to do. We want to partner up with you so that you can spend more time focusing on your client’s needs.
Our Services
Specialized Billing
We can bill for Licensed Midwives, Certified Midwives, Birthing Centers and Doulas.
Insurance Collections
You can transfer old accounts to us that you have previously filed claims on and we will collect from the insurance company.
Custom Claims
We will determine the best approach to filing your claims either global or itemized. Our goal is for you to receive the maximum reimbursement for your services. We are highly skilled at billing transfers.
Verification of Benefits
We personally call the insurance company to verify your clients’ benefits for maternity services and well woman care.
Claim Filing & Follow Up
All claims are filed daily and electronically using the latest industry technology unless a paper claim is required. Follow up calls are made regularly and payment pursued aggressively.
Appeal Letters
Often claims will process based upon “usual, customary and reasonable rates’’ or “non-covered” guidelines. Insurance companies will use these terms to reduce payment. In these cases we will appeal the claims to maximize your reimbursement.
Medipass Referrals
We will obtain the Medipass referral from your clients PCP if your client is a Medicaid recipient who is enrolled in the Medipass program.
Predetermination Letter
Some insurance policies are self funded or out of state and although they may provide maternity coverage, they do not follow state law. In these cases we will work with the insurance company to have the services considered outside the terms of the policy.
Authorizations
Some policies require an authorization in order for services to be covered, in these cases we will obtain the necessary authorization.
Gap Exception Requests
If an insurance policy has both in and out of network benefits and you are not in the network, we can often request a “gap exception” to have the services considered in network.
Referral Request
Certain plans require a referral from a PCP (Primary Care Provider) in order for services to be covered. We will contact your client’s PCP directly and obtain the necessary referral.
Rate Negotiation
We will always negotiate the best possible rate for your services with any plan that is requiring a single case rate (per individual client.) These are often called LOA’s, Letters of Agreement.
Contract Negotiation
Should you wish to contract with any insurance companies, we will be happy to advise you and once discussed handle the entire process for you.
Additional Info
If you would like to find out more about how we can help you, or if you have questions about our contract rates, please contact us by calling, e-mailing us or filling out the form on the Contact Us page.