Coverage varies from insurance company to insurance company, and even from plan to plan within each company. It's complicated, so it’s best to do the Insurance Snapshot to find out about your coverage so that there are no surprises. All clients billing insurance are required to complete the Insurance Snapshot with Larsen Billing Service prior to their first visit with us. Some plans have requirements for prior authorizations or other provisions, and the only way for us to be certain of the best way to cover your care is for you to register with Larsen Billing before coming into our care.
Keep in mind that we bill insurance as a courtesy to you. Your contract for insurance payment is between you and your health insurance company. We will do our best to help you understand your coverage, but you are responsible for verifying that your insurance will cover the care we provide. Ultimately, you are responsible for the cost of your care with us, as with any provider.
If you do not register with Larsen Billing before your first visit, your visits will be self-pay and due at the time of service (non-refundable fee of $250 for the initial visit and $150 for each subsequent visit until you complete your Insurance Snapshot with Larsen Billing). Once you register with Larsen Billing, they will send you a payment plan to estimate your financial responsibility for your care. Our billing representative is Ginger Burkett, and she can be reached via email at email@example.com or by phone at (801) 396-5185 Ext. 144. Ginger is happy to answer your questions.
All clients must pay a non-refundable registration fee to hold their spot on our calendar. This fee is $500 and is due at the first visit.
Birth center care involves two types of fees: Provider fees and Facility fees. Provider fees include all of your prenatal, birth, postpartum, and baby care provided by our midwives. Facility fees cover the use of the facility for your baby's birth. Costs have increased significantly for us over the past few years, but insurance reimbursement has not. Due to inadequate reimbursement and restrictions that have resulted in unpleasant surprises from insurance companies, we have unfortunately needed to terminate some of our contracts and are only billing out-of-network to these carriers.
Premier Birth Center's midwifery care is in-network with most CIGNA and United Healthcare insurance plans. We are currently out-of-network for provider fees for all other insurance carriers.
Both facilities are in-network with Aetna, CIGNA, and United Healthcare for birth center facility fees. The Chantilly birth center is also in-network with CareFirst HMO and PPO/POS plans. We are not contracted with CareFirst for birth center facility fees at our Winchester location.
Other plans may cover the facility fee according to your insurance plan's out-of-network rate or may offer GAP Exceptions. If you have out-of-network coverage for facility fees, we will attempt to bill your insurance for facility services so it will apply to your out-of-network deductible, and you may receive a partial refund of your facility fee deposit if they pay those claims. We do not guarantee facility fee reimbursement for out-of-network plans.
Home Birth Fee
All clients planning a home birth must pay $1500 as a home birth fee. This is not reimbursable by insurance. The only exception to this is for clients who have CIGNA. CIGNA covers the home birth fee. The home birth fee covers the cost of the RN Birth Assistant and the use of our equipment for your birth. You will also need to purchase a home birth kit that contains all of the disposable supplies for your birth, and you may need to rent a birth pool if you plan a water birth and do not have a tub that will work well for that. Birth pool rentals vary but are typically between $150 and $250, depending on the pool you use.
Labs are billed directly to your insurance. You may receive a bill from Quest or LabCorp for any copay required by your insurance plan. Ultrasounds are in-network with insurance or are available for $185 as a self-pay option at the Chantilly location. However, if you prefer to use an imaging center or maternal-fetal medicine practice, we can refer you to the provider of your choice.
We are Medicaid providers, and our midwifery services are covered by United Healthcare Community Plan (Medicaid MCO). There are some fees not covered by Medicaid plans, so those would be an out-of-pocket expense. This would include either a $1500 facility fee or home birth fee. However, we may be able to help you get a GAP Exception with United Healthcare Community Plan for birth center facility fees. If they approve a GAP Exception, you will not need to pay anything for birth center care. Contact us to learn more. You are required to register with Larsen Billing before coming into our care. There is no fee to register with Larsen Billing for people with Medicaid.
Aetna does cover midwifery care at the birth center (at the out-of-network rate) and is in-network for facility fees. However, Aetna has a very strong anti-homebirth policy. Aetna considers "planned deliveries at home and associated services not medically appropriate," so they will not cover any prenatal, birth, postpartum, or baby care if you choose to give birth at home. With this in mind, if you are planning a home birth, our services will be 100% out of pocket.
Healthshare programs like Samaritan Ministries (Classic), Liberty HealthShare, Medi-Share, and Christian Healthcare Ministries (Gold) generally cover our care almost 100%. We often do not require any prepayment for Samaritan Ministries Classic or Christian Healthcare Ministries Gold plans. For other Christian sharing plans, we may require paying a portion based on your sharing plan's requirements.
Not covered by any of these plans? We also have affordable self-pay plans. Contact us and we will find the best solution to suit you.
Christian Healthcare Ministries