Midwives' Advantage was started by a midwife that wanted to see insurance claims for midwives and their clients paid fairly. Her reasoning was the healthcare services of professionals trained to monitor pregnancy, provide nutritional education, attend labor/delivery and provide postpartum follow-up should be paid the same regardless of the location those services were provided or the educational route of the provider or the initials granted to those individuals following training.
In all fairness, if an insurance policy covers maternity care, the location of delivery and the initials behind the healthcare provider's name are irrelevant. Anything less is discrimination.
The Mother's and Newborn Protection Act requires payers to recognize and pay for the services of any healthcare provider acting within the scope of their practice. This policy includes midwives as there are no exclusions or exceptions. The same law cleverly states "hospital birth is not mandated." What a beautiful way to include birth centers, mobile birth facilities, portable facilities and homes.
Our journey billing for midwives began in 1997 and was a long process fighting for the rights of families that had private health insurance that covered maternity care. These members sadly found their maternity claims were denied based on the location of their delivery or the type of provider attending them. Things changed in for the better in 2010 when partnerships with key people in the insurance and legal industries gave our company the legal structure needed to advance to a new level of success and secure agreements with insurance companies to honor claims for their members that chose to be seen by a professional other than an OB/GYN and to have birth outside of hospitals.
Over the years, we have moved from paper billing and ICD-9 diagnosis codes to electronic submission and the new ICD-10 codes for diagnosis. We've seen the efficiency of electronic charting and many other improvements in communications between midwives, their clients and insurance payers.
We are excited to be a positive force in the healthcare industry and to do our part to see that consumers that choose to seek care outside of the hospital are treated fairly when it comes to their claims being paid.
We get most insurance claims paid quickly and fairly! Everybody wins! Insurance companies pay as they should, consumers get to use their maternity benefits and midwives get paid for their dedicated work in providing healthcare.