This form doesn't obligate you or your midwife to file claims with us.
Complete information helps us obtain the most accurate coverage of your policy.
Complete information helps us obtain the most accurate coverage of your policy.
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When you're ready, click the Submit button. This will redirect you to Adobe Sign, a platform where you can authorize your midwife as your insurance's Authorized Representative. This authorization lets us communicate with your insurance company if we file your claims.
We apologize for the repetitive fields on this page and the authorization document. Please complete all fields accurately so your claims are processed promptly. Midwives Advantage will not send your insurance company the Terms of Agreement (the last page). We included it to clarify items that other parents have had questions about.
We wish you the best during your pregnancy and birth!
We apologize for the repetitive fields on this page and the authorization document. Please complete all fields accurately so your claims are processed promptly. Midwives Advantage will not send your insurance company the Terms of Agreement (the last page). We included it to clarify items that other parents have had questions about.
We wish you the best during your pregnancy and birth!
We will send your insurance benefits to your midwife.