Accurate diagnosis can have a significant impact on the midwifery practice's claim for billing. It is evident to us that coding and billing are among the most crucial elements in every midwifery clinic. The accuracy within each of them is essential to ensure the safety of patients, quick payments and effective operations.
 
Historically speaking midwives, other health care providers and payers were on the same page' with regard to fee-for-service reimbursements. Midwives performed a task and the they earned the payment. Simple and straightforward. However, with reforms in healthcare is the requirement for health care professionals to be precise and thorough in the diagnosis codes they use. The shift to pay-for-performance (P4P) programs, originally initiated by the CMS, but increasingly adopted by private payers, demands this accuracy. Along with offering incentives to Midwives for providing quality care, there are now penalties for midwives and other health care professionals who may not be offering patient care of acceptable quality. With this reform, accurate diagnosis became a top priority in order for midwives to claim bills accurately, here’s the reasons why.

Accuracy Was Always an Issue
While accurately recording diagnosis codes has always been important, until P4P programs, many payers accepted marginally thorough supporting information to approve claims and pay providers. The new emphasis on claims clarity often proves to be challenging for midwives and billing staff, particularly for those providers not in the habit of submitting fully documented reimbursement claims.
In the past, claims with faulty diagnosis codes typically were denied. Yet, some insufficiently explained claim submissions slipped through and were approved. If payer claim reviewers were hurried into claim examinations, it was always possible that some submissions that could have had payers ‘scratching their heads’ were approved.
 
However, most of the diagnosis coding rules have changed. Accuracy, always a factor, has become the primary component of claims approval. Along with approved/rejected decisions, medical providers now face quality care issues, requiring further justification and explanation to eliminate payer confusion.

Proper Diagnosis Critical for Payment
Some midwives and billing personnel seem forgetful that Medicare Advantage plans pay, in part, as a function of the number and severity of sickness in the total population of patients. CMS calculates variable per month payments based on the levels of the ‘sick’ population. Some private payers are endorsing this approach, demanding that physician diagnosis coding ‘fits’ the matrix.
 
While some midwives during the fee-for-service era always went the extra mile to fully explain their diagnostic coding and process, many other providers, often because of billing staff time constraints, neglected to thoroughly document their diagnosis procedures. However, providers now risk facing claim denials with P4P programs if payer review staff is unsure that the doctor performed diagnostic services that were necessary to design a treatment plan.
 
Accurate and thorough coding for chronic conditions is another prime area of payer scrutiny. ICD-9 guidelines require providers to use these codes ‘as often as applicable’ when treating chronic conditions. P4P quality care evaluation depends on proper use of these codes. The penalty consequences of taking coding ‘shortcuts’ can result in lower income for the midwife.
 
These are some of the reasons that using accurate diagnosis codes are critical for maximum claim approvals and CMS decisions that physician care qualifies as meeting quality guidelines. The strong focus on procedural diagnostic coding accuracy is here—possibly affecting your compliance and income levels.
 
Accurate diagnosis coding, backed up by thorough documentation regarding the necessity of diagnostic procedures, is no longer a payer ‘luxury.’ Accuracy and clarity are now a necessity for all physicians. Achieving this result typically demands some combination of the following actions.

• Designing an almost foolproof internal procedure for billing staff or midwives to review all claim submissions for accurate diagnosis codes and supporting document clarity.
• Have experienced coders review EHR document derived diagnostic codes before submitting claims.
• Retaining a leading independent coding and documentation firm, to assume the responsibility of submitting accurate, clearly explained diagnostic procedure claims for you.
• Midwives developing the habit of fully documenting all diagnostic procedures for every patient, helping billing staff and payer reviewers to understand the reasons for the diagnosis process used.

 
Midwives and other healthcare practices using these tips should remain in HIPAA, CMS and P4P compliance, maintain or increase revenue and create evidence of delivering quality care to all patients. Properly using diagnosis codes and supporting your diagnostic procedures with valid documentation will achieve these results.

Reference

Diagnosis coding has taken center stage in medical billing. Coronis. (n.d.). Retrieved September 29, 2022, from https://www.coronishealth.com/blog/diagnosis-coding-has-taken-center-stage-in-medical-billing/ 

Insurance fraud is any act made to deceive an insurance procedure. It occurs when a claimant attempts to obtain some benefit or advantage they are not entitled to, or when an insurer knowingly denies some benefit that is due. It is also a deliberate deception perpetrated against or by an insurance company or agent for the purpose of financial gain. Fraud may be committed at different points by applicants, policyholders, third-party claimants, or professionals who provide services to claimants. Insurance agents and company employees may also commit insurance fraud. Common frauds include “padding,” or inflating claims; misrepresenting facts on an insurance application; submitting claims for injuries or damage that never occurred; and staging accidents.
​
People who commit insurance fraud include:

• organized criminals who steal large sums through fraudulent business activities,
• professionals and technicians who inflate service costs or charge for services not rendered, and
• ordinary people who want to cover their deductible or view filing a claim as an opportunity to

Inside the healthcare industry lies good opportunity for insurance fraud as well. Insurance fraud causes tens of billions of dollars in losses each year. It can raise health insurance premiums, expose you to unnecessary medical procedures, and increase taxes. If you’re in the healthcare industry, you must learn to identify what are the common types of healthcare and insurance fraud.
Common types of healthcare and insurance fraud:
1. Fraud Committed by Medical Providers

• Double billing: Submitting multiple claims for the same service
• Phantom billing: Billing for a service visit or supplies the patient never received
• Unbundling: Submitting multiple bills for the same service
• Upcoding: Billing for a more expensive service than the patient actually received
  

2. Fraud Committed by Patients and Other Individuals

• Bogus marketing: Convincing people to provide their health insurance identification number and other personal information to bill for non-rendered services, steal their identity, or enroll them in a fake benefit plan
• Identity theft/identity swapping: Using another person’s health insurance or allowing another person to use your insurance
• Impersonating a health care professional: Providing or billing for health services or equipment without a license
  

3. Fraud Involving Prescriptions

• Forgery: Creating or using forged prescriptions
• Diversion: Diverting legal prescriptions for illegal uses, such as selling your prescription medication
• Doctor shopping: Visiting multiple providers to get prescriptions for controlled substances or getting prescriptions from medical offices that engage in unethical practices

 
How to Prevent Insurance Fraud?
 
The Affordable Care Act of 2010 included fraud-fighting efforts, such as allowing the U.S. Department of Health and Human Services (HHS) to exclude providers who lie on their applications from enrolling in Medicare and Medicaid and the Improper Payments Elimination and Recovery Act, which requires agencies to conduct recovery audits for programs every three years and develop corrective action plans for preventing future fraud and waste.
Other efforts included:

• Implementing an Automated Provider Screening system to review enrollment applications;
• Allowing HHS to impose a temporary moratorium on newly enrolled providers or suppliers, if necessary to combat fraud;
• Authorizing the Centers for Medicare and Medicaid Services, in conjunction with the Office of the Inspector General, to suspend payments to providers or suppliers during the investigation of a credible allegation of fraud; and
• Ensuring that providers and suppliers found guilty of fraud in one of the Centers’ systems, such as Medicare, cannot have service privileges in another area, such as Medicaid, or within state programs.

 
Additionally, in 2012, HHS and the Department of Justice formed the National Fraud Prevention Partnership to combat health care fraud. The group also consists of private and public groups such as health care companies and their organizations, the National Association of Insurance Commissioners, the National Insurance Crime Bureau and the National Health Care Anti-Fraud Association. The groups will share information on claims from Medicare, Medicaid. and private insurance to be administered by a third-
party vendor.
 
Fraudulent acts have no escape with the law. Whether you’re a healthcare provider trying to slip away money from your clients, or a client who doesn’t one to compensate the services provided to you.  Either way, one must be vigilant enough to take part in protecting his/her right and preventing these things to happen.  Keep all your records intact and avoid providing your information to anyone asking for it. Always verify, verify, verify!
 
Reference

Background on: Insurance fraud. III. (n.d.). Retrieved June 18, 2022, from https://www.iii.org/article/background-on-insurance-fraud

Through the years, the field of midwifery as a profession has been the subject of a variety of misconceptions that can go as far as the idea of comparing midwives to quacks. Even today, the job of a midwife can be misinterpreted as simply helping births. Often times, midwives experience misconception about the true quality of service they provide, as it is not only vital for all women and newborns to access care – it is critical that this care is of a sufficient quality to provide a safe and positive childbirth experience, and that it is provided with respect and dignity.
 
Midwives should be recognized for the excellent the services they provide. It's not a flimsy hoax. There are a few reasons to believe it;

• The possibility of midwives for enhancing the quality-of-care 83 percent of all stillbirths, maternal deaths, and newborn deaths could be prevented with the full package of midwifery care (including family planning);
• 62 percent of successful practices within the scope of midwifery reveal the importance of optimizing the normal procedures of childbirth and early life and enabling girls to take care of themselves and their families;
• 56 maternal and neonatal results were found to be enhanced through midwifery philosophy and practice of care;
• 87 percent of service demand can be delivered by midwives when trained to international standards;
• 82% decrease in maternal mortality potential with universal midwifery policy
• Midwifery is related to more efficient utilization of resources and improved results when supplied by educated, trained, licensed, and regulated midwives in global standards. Midwifery is a ‘best buy’ investment;
• Midwifery is associated with decreased maternal and neonatal morbidity, decreased interventions in labor, enhanced psycho-social results, and increased contraceptive use and birth spacing
• Community-based midwives have been found to rank favorably for economy, efficiency, and effectiveness;
• Midwifery ought to be considered a core component of universal health care. Quality midwifery care is essential to achieving national and international priorities and securing the rights of women and newborn babies;
• Quality relates to the right for teens and women to the maximum standard of health and is interchangeable with women-centered care. Providing quality care is most effective through midwifery care for all childbearing women;
• There were no adverse effects associated with midwife-led care but important advantages, so it is suggested that all women should be provided midwife-driven continuity models of care;
• Midwives can provide excellent quality of care, but socio-cultural, professional, and economic barriers have to be overcome to practice to their full potential.
• Case loading midwifery care is safe and cost-effective.

 
Ways To Increase Awareness

1. Get a proclamation acknowledging this day from the local officials or governor. Make preparations to pick up local assertions yourself or send a representative of your company or a group of midwifery supporters. Try to get media coverage.
2. Plan a potluck dinner, a picnic in the park, or a rally for the families you’ve served. Think about opening it to the public and media (“come talk with a few homebirth families” or”come see why these families used a midwife”).
3. Have an Open House in your workplace. Invite the mayor, governor, or your legislator to your occasion. Invite local physicians, nurses, hospital administrators, and health officials. Have a demonstration ready describing the benefits of midwifery care.
4. Participate in a TV or radio talk-show or interview.
5. Organize a church ceremony or plant a tree at a local park to commemorate the day.
6. Office supply stores now have stationery items like greeting cards and postcards, which feed through your printer.
7. Create and distribute flyers about International Midwives’ Day and midwifery. Send out to the general public, legislators, policymakers, insurance companies, etc. Send legislators a “new constituent birth announcement.”
8. Have a gathering of midwives. Send all of the midwives a copy of your proclamation in your community if you can copy it on special paper. Frame it and take the regional midwife out to lunch and present her statement as an award. Call some customers to join you and invite the media to an (inexpensive, easy to arrange ) Award Ceremony in honor of the day.
9. Wear lapel ribbons representing the day (in Michigan, they wear pink and blue ribbons). Let folks at other meetings you attend understand that International Midwives Day is coming up. Take some ribbons together, distribute them, and ask people to wear them on May 5.
10. Send out Public Service Announcements to TV and local radio.
11. Prepare to have a display or a booth in a health or shopping mall, women’s, or children’s fairs.
12. Give excellent gifts to infants born on International Midwives’ Day. Send their pictures to the newspaper with birth news.

 
Midwifery is proficient, educated, and compassionate care for childbearing women, newborn babies, and families throughout the pre-pregnancy, pregnancy, childbirth, postpartum, and the early weeks of life. Indeed, midwives are valuable sector of the society and that they need to receive the recognition they deserve.

Reference

Barker, J. (2021, February 13). Midwives do not get the recognition they deserve! Blog About Midwives & Doulas. Retrieved September 30, 2022, from https://www.fruitfulwombs.com/midwives-do-not-get-the-recognition-they-deserve/#:~:text=The%20Pros%20For%20Midwifery%3A&text=Quality%20midwifery%20care%20is%20essential,interchangeable%20with%20women%2Dcentered%20care.

The implementation of Affordable Care Act (ACA) has greatly influenced the healthcare industry across United States. Study shows that ACA has reduced the number of uninsured people to historically low levels and helped more people access health care services, especially low-income people and people of color. However, the law’s effects on the cost and quality of health care services are difficult to discern given the complexity of our health system.
 
Since its passage, midwives gained opportunities to provide better maternal health access to mothers as the ACA helped to improve the quality of coverage for pregnant and birthing people by requiring individual and small group plans, as well as Medicaid expansion plans, to cover maternity and newborn care.
 
What is Affordable Care Act?
 
Signed into law on March 23, 2010, the Affordable Care Act (ACA) contains numerous provisions impacting a wide range of health care related issues.  The overarching goals of the legislation were to increase the number of people with insurance coverage, improve the design of existing policies, and increase the quality of care provided in the U.S., all while taking significant steps to control costs.
 
Key issues for midwives include:

• Increasing Medicare reimbursement for midwives to 100% of that received by physicians
• Requiring Medicaid programs to provide coverage for birth center services and the services of providers working in birth centers
• Expansion of the eligibility criteria for Medicaid  
• Creation of the new Health Insurance Marketplaces and requirements related to plans offered through the Marketplaces
• Defining the "essential health benefits" (EHB) that must be covered by insurers both inside and outside of the Marketplaces
• Providing assistance for education of midwives 

Under the law, all individual and small employer insurance plans, including those you get through the Marketplace, must cover maternity and newborn care -- before and after your baby is born.* In the past, most plans sold outside your job didn’t offer much maternity coverage. Some didn't cover it at all.
 
The ACA doesn't spell out all of the specific benefits that must be covered while you're pregnant and after the baby is born. But many preventive care services must be covered without extra out-of-pocket costs, like co-pays, co-insurance, or deductibles. For mothers, that includes preventive services for preconception and prenatal care and well-baby check-ups plus comprehensive lactation support, counseling, and breastfeeding equipment. Listed below are the codes included in the Affordable Care Act (ACA) that midwives can bill as they provide services.
 

1. CHLAMYDIA SCREENING LAB TEST*

• CPT CODE(S)
  • 86631 Chlamydia antibody
  • 86632 Chlamydia IGm
  • 87110 Chlamydia culture any source
  • 87270 Chlamydia antigen detection by immunofluorescent technique
  • 87320 Chlamydia antigen detection by enzyme immunoassay technique 87490 Chlamydia direct probe technique
  • 87491 Chlamydia amplified probe technique
  • 87492 Chlamydia quantification 87801 Infectious agent detection by DNA or RNA, direct probe technique
  • 87810 Chlamydia antigen detection by immunoassay with direct optical observation
  • 36415 Venipuncture if performed**
  • 99000 Handling and preparation of specimens if sending to an outside lab, and clinic incurs the cost for transporting them**
• Suggested ICD-10 CODE(S)
  • Z11.8 Encounter for screening for other infectious and parasitic disease†
  • Z11.3 Encounter for screening for infections with a predominantly sexual mode of transmission†

  
     2. GONORRHEA SCREENING LAB TEST*

• CPT CODE(S)
  • 87590 Neisseria gonorrhea, direct probe technique
  • 87591 Neisseria gonorrhea, amplified probe technique
  • 87592 Neisseria gonorrhea, quantification
  • 87801 Infectious agent detection by DNA or RNA, direct probe technique 87850 Neisseria gonorrhea antigen detection by immunoassay with direct optical observation
  • 36415 Venipuncture if performed**
  • 99000 Handling and preparation of specimens if sending to an outside lab, and clinic incurs the cost for transporting them**
• Suggested ICD-10 CODE(S)
  • Z11.3 Encounter for screening for infections with a predominantly sexual mode of transmission†
  • Z11. 2 Encounter for screening for other bacterial diseases†
    

     3. HIV SCREENING LAB TEST*

• CPT CODE(S)
  • 86689 HIV antibody confirmatory test (e.g., Western blot)
  • 86701 HIV-1 antibody 86701
  • HIV-2 antibody 86703 HIV-1 & HIV-2 antibody
  • 87389 Infectious agent antigen detection by immunoassay, EIA, ELISA, IMCA, HIV-1 antigens, HIV-1 and HIV-2 antibodies) 87391 Infectious agent antigen detection by immunoassay, EIA, ELISA, IMCA, HIV-2)
  • 36415 Venipuncture if performed**
  • 99000 Handling and preparation of specimens if sending to an outside lab, and clinic incurs the cost for transporting them**
• Suggested ICD-10 CODE(S)
  • Z11.4 Encounter for screening HIV†
    

     4. SYPHILIS SCREENING LAB TEST*

• CPT CODE(S)
  • 86592 Syphilis test, qualitative (e.g., VDRL, RPR)
  • 86593 Syphilis test, quantitative (e.g., VDRL, RPR)
  • 36415 Venipuncture if performed**
  • 99000 Handling and preparation of specimens if sending to an outside lab, and clinic incurs the cost for transporting them**
• Suggested ICD-10 CODE(S)
  • Z11.3 Encounter for screening for infections with a predominantly sexual mode of transmission†
  • Z11.2 Encounter for screening for other bacterial diseases

 
   5. BEHAVIORAL COUNSELING TO PREVENT SEXUALLY TRANSMITTED INFECTIONS(If the patient has sign, symptom, or has been exposed to an infection, use appropriate ICD-10 code and 99201–99215)

• CPT CODE(S)
  • 99401 Preventive counseling or risk factor reduction: 15 mins‡
  • 99402 Preventive counseling or risk factor reduction: 30 mins‡
  • 99403 Preventive counseling or risk factor reduction: 45 mins‡
  • 99404 Preventive counseling or risk factor reduction: 60 mins‡
• Option 2

• New patient problem visit: 99201-99205 Established patient problem visit: 99211-99215
• These visits may also be reported based on counseling time. If counseling or coordination of care accounts for more than 50% of the visit, then select the E/M code (99201–99215) based on the length of the visit. Not all payers will reimburse these codes with a corresponding ICD10 preventive service Z code. For private insurance, append modifier 33 to the E/M code to indicate it is a preventive service

• Suggested ICD-10 CODE(S)
  • Z71.7 Human immunodeficiency virus [HIV] counseling
  • Z71.89 Other specified counseling (other than HIV)

 
   6. CONTRACEPTIVE COUNSELING(If the patient has a side effect from current method or menstrual irregularity, use ICD-10 code for sign or symptom and 99201–99215. When a patient presents with a problem, it is not appropriate to report a preventive CPT code)

• CPT CODE(S)
  • 99401 Preventive counseling or risk factor reduction: 15 mins‡
  • 99402 Preventive counseling or risk factor reduction: 30 mins‡
  • 99403 Preventive counseling or risk factor reduction: 45 mins‡
  • 99404 Preventive counseling or risk factor reduction: 60 mins‡
• Option 2
  • New patient problem visit: 99201-99205 Established patient problem visit: 99211-99215
  • These visits may also be reported based on counseling time. If counseling or coordination of care accounts for more than 50% of the visit, then select the E/M code (99201–99215) based on the length of the visit. Not all payers will reimburse these codes with a corresponding ICD10 preventive service Z code. For private insurance, append modifier 33 to the E/M code to indicate it is a preventive service

• Suggested ICD-10 CODE(S)
  • Z30.09 Encounter for other general counseling and advice on contraception
  • Z30.02 Counseling and instruction in natural family planning to avoid pregnancy

 
   7. WELL WOMAN VISIT(Some payers expect that many of these ACA preventive services—counseling, screening, and immunizations—occur during the annual preventive exam and may not reimburse separately for these on the same day or at subsequent visits.)

• CPT CODE(S)
  • Preventive visits for new patients by age: 99381, 99382, 99383, 99384, 99385, 99386, 99387
  • Preventive visits for established patients by age: 99391, 99392, 99393, 99394, 99395, 99396, 99397
• Suggested ICD-10 CODE(S)
  • Z01.411 Encounter for gynecological examination (general) (routine) with abnormal findings
  • Z01.419 Encounter for gynecological examination (general) (routine) without abnormal findings
  • Z00.00 Encounter for general adult medical examination without abnormal findings
  • Z00.01 Encounter for general adult medical examination with abnormal findings Note: These may only be used with preventive visit for new or established patients
• HCPCS CODE(S) Medicare & some commercial payers
  • G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of Medicare enrollment
  • G0438 Annual wellness visit; includes a personalized prevention plan of service, initial visit
  • G0439 Annual wellness visit, includes a personalized prevention plan of service, subsequent visit
  • S0610 Annual gynecological examination, new patient
  • S0612 Annual gynecological examination, established patient
  • S0613 Annual gynecological examination; clinical breast examination without pelvic evaluation
    

     
     8. HUMAN PAPILLOMAVIRUS (HPV) VACCINATIONS
(If not administered during an annual wellness exam, some payers will also reimburse for an office visit)

• CPT CODE(S)
  • 90649 Gardasil® 90650 Cervarix®
  • 90651 Gardasil 9®
  • 90460 Administration of vaccine through age 18 with counseling by provider—any route, 1st
  • 90461 ADD ON CODE: Administration of vaccine through age 18 with counseling by provider—any route, each additional during that encounter 90471 Administration of vaccine over 18—any route, 1st
  • 90472 ADD ON CODE: Administration of vaccine over 18—any route, each additional during that encounter Requires a CPT code for the immunization and a CPT code for the administration
• Suggested ICD-10 CODE(S)
  • Z23 Encounter for immunization
    

     9. HPV DNA LAB TESTING

• CPT CODE(S)
  • 87623 HPV detection by DNA or RNA, low risk
  • 87624 HPV detection by DNA or RNA, high risk
  • 87625 HPV detection by DNA or RNA, types 16 and 18, includes type 45 if performed
• Suggested ICD-10 CODE(S)
  • Z11.51 Encounter for HPV screening
    

    10. HEPATITIS (Hep) A IMMUNIZATION (If not administered during an annual wellness exam, some payers will also reimburse for an office visit)

• CPT CODE(S)
  • 90632 Hep A adult dosage
  • 90633 Hep A pedi/adolescent 2-dose schedule
  • 90634 Hep A pedi/adolescent 3-dose schedule
  • 90636 Hep A and Hep B adult dosage 90460 Administration of vaccine through age 18 with counseling by provider—any route, 1st
  • 90461 ADD ON CODE: Administration of vaccine through age 18 with counseling by provider—any route, each additional during that encounter
  • 90471 Administration of vaccine over 18—any route, 1st
  • 90472 ADD ON CODE: Administration of vaccine over 18—any route, each additional during that encounter
  • Requires a CPT code for the immunization and a CPT code for the administration
• Suggested ICD-10 CODE(S)
  • Z23 Encounter for immunization

 
    11. HEPATITIS (Hep) B IMMUNIZATION I(If not administered during an annual wellness exam, some payers will also reimburse for an office visit.)

• CPT CODE(S)
  • 90636 Hep A and Hep B adult dosage
  • 90739 Hep B adult 2-dose schedule
  • 90740 Hep B for immunosuppressed 3-dose schedule
  • 90743 Hep B adolescent 2-dose schedule
  • 90744 Hep B pedi/adolescent 3-dose schedule
  • 90746 Hep B adult 2-dose schedule 90747 Hepatitis B for immunosupressed 4-dose schedule
  • 90460 Administration of vaccine through age 18 with counseling by provider—any route, 1st
  • 90461 ADD ON CODE: Administration of vaccine through age 18 with counseling by provider—any route, each additional during that encounter
  • 90471 Administration of vaccine over 18—any route, 1st
  • 90472 ADD ON CODE: Administration of vaccine over 18—any route, each additional during that encounter
  • Requires a CPT code for the immunization and a CPT code for the administration

• Suggested ICD-10 CODE(S)
  • Z23 Encounter for immunization

 
​     12. Sexually transmitted infection prevention counseling 

• CPT — A list of sexually transmitted infection CPT codes can be found here. 
• Eligibility: ACA expanded coverage for all adults at high risk of contracting a sexually transmitted disease. 

 
References

Adviser, C. S. S., Seeberger, C., Adviser, S., Director, M. C. A., Coleman, M., Director, A., Shepherd Director, M., Shepherd, M., Director, Director, E. L. A., Lofgren, E., Gordon Director, P., Gordon, P., Director, J. P. S., Parshall, J., Director, S., Williamson, H., Taylor, J., Tausanovitch, A., … Conner, A. (2022, June 9). Building on the ACA: Administrative actions to improve maternal health. Center for American Progress. Retrieved September 28, 2022, from https://www.americanprogress.org/article/building-aca-administrative-actions-improve-maternal-health/

Affordable care act (ACA) - glossary. Glossary | HealthCare.gov. (n.d.). Retrieved September 28, 2022, from https://www.healthcare.gov/glossary/affordable-care-act/

Lamboley, L. (2022, September 19). List of Aca Preventive Services and CPT codes [Prevounce Quick Guide]. Prevounce Blog. Retrieved September 28, 2022, from https://blog.prevounce.com/list-of-aca-preventive-services-and-cpt-codes-prevounce-quick-guide

List of Aca Preventive Services and CPT Codes - Std Tac. (n.d.). Retrieved September 28, 2022, from http://stdtac.org/wp-content/uploads/2014/06/List-of-ACA-Preventative-Services-and-CPT-Codes-_STDTAC.pdf