Congratulations on Choosing a Midwife! 

• ​Please make sure your insurance company has your current mailing address. 
• If your address or insurance policy changes, please complete a new verification of benefits 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

• Corporate Billing: Claims are billed under our affiliated corporate names, not under your provider’s or birth center’s name. Therefore, insurance documents will list our corporate name and a Texas address.
• Insurance Classifications: Due to the use of scissors to cut the newborn's umbilical cord, some insurance companies may classify vaginal deliveries as surgery or the birthing location as an operating room. We submit claims based on the nature of the birth, but insurance companies assign their own descriptions.
• Eligibility Requirements: You must have maternity benefits and out-of-network coverage at the time of service for us to submit your claims. Claims can be processed up to one year from the delivery date.
• Professional Claims: These include prenatal care, delivery, care during transfers, postpartum care, lactation assistance, and newborn exams.
• Facility Claims: These cover labor supplies and care provided during labor, delivery, and the immediate postpartum period. A facility includes any setting for labor and delivery, regardless of licensing. A facility claim covers services for both you and your newborn. If you transfer to a hospital for delivery, a facility claim will still cover labor observation and supplies.
• EOB (Explanation of Benefits): An EOB is a statement from your insurance company, not a bill. You will not receive a bill from your insurance company for these services.
• Financial Agreement: Your out-of-pocket costs are determined by your agreement with your midwife.
• Insurance Payments:
  • Your midwife is independently contracted with Midwives Advantage. We incur hard cost when we submit claims to insurance. We aren't paid for our work until your insurance company pays the claim.
  • Once we receive the insurance payment, we pay your midwife on the next payroll cycle.
• You agree to forward any insurance payments you receive to our payroll department or your midwife for submission to us.

Checks can be mailed to:
     Midwives Advantage
     216 Tower Rd
     San Antonio, TX 78223

• Refunds: Any refund due to you will be issued by your midwife after all payments are processed, and all parties are compensated.
• No Kickback Policy: Patients cannot receive or retain kickbacks from their insurance claims.