MIDWIVES ADVANTAGE
  • Home
    • About Us
    • Our Advantage
  • GET INFO
  • Q&A
  • Midwife Clients
    • Verify My Insurance
    • Information After Claims Are Filed
  • Blog
  • SPD INFO

Midwives
​Advantage
​Blog

Midwifery Billing and Coding Regulation Trends in 2023

5/26/2023

 
Picture
However, based on past trends, here are some things that may be worth considering:
  1. Expansion of Telehealth Coverage: Due to the COVID-19 pandemic, telehealth has become more popular and essential. In 2023, there may be further expansion of telehealth coverage, including more services covered by insurance plans.
  2. Changes to Evaluation and Management (E/M) Coding: The Centers for Medicare & Medicaid Services (CMS) implemented significant changes to E/M coding in 2021. It's possible that further updates or adjustments to E/M coding may be made in 2023.
  3. Increased Focus on Social Determinants of Health: There may be a greater emphasis on addressing social determinants of health in 2023. This could impact coding and billing, as providers may need to document more detailed information on patients' social needs and how they are addressing them.
  4. New or Revised Codes: Each year, new codes are added to the Current Procedural Terminology (CPT) code set. Additionally, existing codes may be revised or deleted. Providers should stay up-to-date with these changes to ensure accurate billing and coding.
  5. Changes to Quality Payment Programs: The CMS Quality Payment Programs (QPPs), such as the Merit-based Incentive Payment System (MIPS), are updated annually. In 2023, there may be changes to these programs that impact billing and coding requirements.
It's important for providers to stay up-to-date with any new regulations and updates that impact billing and coding. You can check with professional organizations, attend conferences or seminars, or consult with billing and coding experts for more information.

Midwife Home Birth Practice Billing Tips

5/19/2023

 
Picture
As a midwife who provides home birth services, billing can be a bit more complicated than traditional hospital birth services. Here are some billing tips to help make the process more manageable:
  1. Verify Insurance Coverage: Before providing services, it's essential to verify the patient's insurance coverage for home birth services. Some insurance plans do not cover home births, and some may require pre-authorization or additional documentation.
  2. Use Correct Coding: Accurate coding is essential for successful insurance billing. Use Current Procedural Terminology (CPT) codes to bill for your services. For home births, you may need to use additional codes, such as a place of service code that indicates the service was provided in the patient's home.
  3. Bill for All Services: Be sure to bill for all services provided, including prenatal care, delivery, and postpartum care. Each service should be billed separately using the appropriate codes.
  4. Document Care: Accurate documentation is crucial for successful insurance billing. Be sure to document all services provided, including the date, time, and nature of the service.
  5. Consider a Global Fee: Some midwives prefer to use a global fee for home birth services, which includes all prenatal, delivery, and postpartum care. This simplifies billing and reduces administrative work.
  6. Use an Electronic Billing System: Using an electronic billing system can streamline the billing process and reduce errors. Many systems are available specifically for midwives and home birth practices.
  7. Follow Up on Claims: Insurance companies can take time to process claims, so it's important to follow up regularly to ensure timely payment. If a claim is denied, you may need to resubmit it with additional documentation or appeal the decision.
Remember, billing for home birth services as a midwife can be challenging, but with the right tools and knowledge, it can be a manageable process. Don't hesitate to seek the help of a billing professional or billing service if needed. We love helping midwives get paid what they are worth!  Set up a discovery call today.

Billing and Coding for Midwives

5/12/2023

 
Picture
Midwives have many responsibilities in caring for mothers and baby. There isn't enough time in a midwife's day to become an expert in coding and billing.  Billing procedures are often complicated and change from payer to payer. Birth Centers and midwives across 38 states have decided that nothing compares to the results produced by Midwives Advantage!   

Consistency and persistence in processing maternity claims has established Midwives Advantage as the go-to provider for maternity claims submissions.

Midwife Billing Insurance Plans Made Simple

5/5/2023

 
Picture
As a midwife, billing insurance plans can seem complicated at first, but with a little guidance, it can become more straightforward. Here are some simple steps to help you understand how to bill insurance plans as a midwife:
  1. Verify Insurance Coverage: Before scheduling an appointment with a patient, it's essential to verify their insurance coverage. You can do this by contacting the patient's insurance company directly or using an electronic eligibility tool.
  2. Understand the Insurance Plan: Each insurance plan has its own set of guidelines and requirements for billing. Review the patient's insurance policy to understand the specific coverage and billing requirements.
  3. Use Correct Coding: Accurate coding is essential for successful insurance billing. You will need to use Current Procedural Terminology (CPT) codes to bill for your services. You can find these codes in the CPT manual or by using an online coding tool.
  4. Submit Claims: Once you've provided services to a patient, you can submit a claim to the insurance company for reimbursement. This can be done electronically or by paper.
  5. Follow Up on Claims: Insurance companies can take time to process claims, so it's important to follow up regularly to ensure timely payment. If a claim is denied, you may need to resubmit it with additional documentation or appeal the decision.
  6. Consider a Billing Service: If billing insurance plans seems overwhelming, consider using a billing service that specializes in midwifery billing. They can help you navigate the insurance process and ensure timely payment for your services.
Remember, billing insurance plans as a midwife can be challenging, but with the right tools and knowledge, it can be a manageable process. We would love to help you with your midwife billing needs.  Schedule a discovery call today!

    Archives

    August 2023
    July 2023
    June 2023
    May 2023
    April 2023
    March 2023
    February 2023
    January 2023
    December 2022
    November 2022
    October 2022
    September 2022
    August 2022
    July 2022
    June 2022
    May 2022
    April 2022

    Categories

    All
    Billing & Coding Regulation Changes
    Billing Tips
    Midwifery Billing Trends
    Midwives Advantage Reimbursement Updates
    New Billing Resources

    RSS Feed

 Copyright 2022 Midwives Advantage
  • Home
    • About Us
    • Our Advantage
  • GET INFO
  • Q&A
  • Midwife Clients
    • Verify My Insurance
    • Information After Claims Are Filed
  • Blog
  • SPD INFO