Congratulations on Choosing a Midwife!
- Our services are only for people using a midwife that is part of our company.
- Ask your midwife if she is registered with Midwives Advantage for claims submission before sending your insurance information.
- Please make sure your insurance company has your current mailing address.
- If your address or insurance policy changes, please update us.
- Follow this link to complete patient insurance information form.
How Midwives Advantage Works
Midwives Advantage contracts with midwives and their clientele to submit claims to insurance companies for maternity services. Midwives become a part of our corporation as contracted providers, and they gain a back-office staff to verify insurance benefits, submit claims, and process insurance payments.
GENERAL INFORMATION
GENERAL INFORMATION
- Claims are billed under our affiliated corporate names, not your provider/birth center name. As such, Explanation of Benefits (EOB)/documents from insurance detailing the claims submitted for care will have our corporate name and the corporate claim correspondence address (Texas or Colorado) on them.
- Due to the use of a surgical instrument (scissors) to cut the newborn's umbilical cord, some insurances will classify a vaginal delivery as surgery or to the facility as an operating room. We submit charges based on how/where the birth was performed, but the insurance companies get to decide on their own naming conventions.
- You must have maternity benefits and out-of-network coverage at the time of service for us to be able to submit your claims. Claims can be processed up to one year from the date of delivery.
- Professional claims are for prenatal care, delivery, care during a transfer, postpartum care, lactation assistance, and newborn exams.
- Facility claims are for the supplies and care provided during labor. A facility is any entity that provides a setting for labor, delivery, and immediate postpartum. Licensing is not a requirement to qualify as a birthing center. A facility claim is filed for you and your newborn whether the equipment for birth is taken to you (home) or you travel to the location (birth center) of the equipment for birth.
- If your labor requires a transfer to the hospital for delivery, a facility claim will be submitted to cover labor observation and supplies for labor.
- Our fee is 35% of the total paid on all claims.
- Regardless of what an EOB might state, your financial agreement with your midwife determines your out-of-pocket expenses, not your insurance company.
- Your provider is independently contracted with Midwives Advantage. Once we receive the insurance payment, we pay your provider on the next payroll cycle.
- In the event the insurance company sends the check to you, you agree to send the check to us via mail or electronic deposit. If you choose to mail the check, it should be addressed to our payroll office: Midwives Advantage, 216 Tower Rd, San Antonio, TX 78232. To deposit electronically, you will need to install the Chase Banking app on your device, and you will be provided a login to make the deposit. Watch a quick video to see how easy mobile deposits are.
- If we do not receive the funds, the claim will be voided, and the insurance will demand full repayment of funds.
- Any refund due to you will be issued to you by your midwife after the payment is processed, and all parties are compensated.
- Patients cannot profit from their insurance.