Health Plans We Accept
Coverage varies from insurance company to insurance company, and even from plan to plan within each company. It’s best to do the Verification of Benefits to find out about your coverage so that there are no surprises. All of our clients billing insurance are required to verify their commercial insurance coverage 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 prior to coming into our care. 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 VOB with Larsen Billing). Once you register with Larsen Billing, they will send you a payment plan with an estimate of 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.
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 use of the facility for your baby's birth.
Premier Birth Center's midwifery care is in-network with Aetna, United Healthcare, and Anthem/Blue Cross Blue Shield. CareFirst processes provider clams through Anthem BCBS. CareFirst is in-network for non-HMO plans in Chantilly, and is in-network for all plans in Winchester. In Winchester, we are temporarily not accepting new clients who wish to bill any of the Blue Cross/Blue Shield plans or Tricare. We hope to have this resolved soon and will update our website when that changes. In the meantime, people with those plans will be self-pay. People who have Anthem Healthkeepers Medicaid plans can request DMAS to change to United Healthcare Community Plan or Medicaid Fee for Service if they wish to use our Winchester location. Both birth centers will soon be contracted with other commercial plans. Other plans have reimbursement based on your out-of-network benefits. There are some costs not covered by insurance. Contact us to learn more about that.
Both facilities are in-network with Aetna. The Chantilly birth center is also in-network with CareFirst. We are not contracted with CareFirst for Facility Fees at our Winchester location. The Chantilly birth center is in-network with United Healthcare for facility fees and has a contract pending for the Winchester location. Other plans may cover the facility fee according to your insurance plan's out-of-network rate. If you have out-of-network coverage for facility fees, we will attempt to bill your insurance for facility services so that it will apply to your out-of-network deductible, and you may receive a 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 are required to pay $1500 as a home birth fee. This is not reimbursable by insurance. 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 give you a referral to the provider of your choice.
We are Medicaid providers, and our midwifery services are covered by Anthem Healthkeepers Chantilly only) and United Community Health Plan (both locations). If you are covered under another Medicaid MCO, you will need to change your MCO selection. We recommend United Healthcare's United Community Plan. Medicaid covers the provider fees only. Our preferred Medicaid MCO is United Healthcare's Community Plan. 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. Contact us to learn more. You are required to register with Larsen Billing prior to coming into our care. There is no fee to register with Larsen Billing for people with Medicaid.
Tricare Select pays for the much of your care with Premier Birth Center. Both birth centers are Tricare Certified, but we are currently accepting Tricare only at our Chantilly location. People with Tricare Prime may be covered with a referral from their PCP. Contact us to learn more.
Aetna does cover birth center care and is in-network for both the facility fees and the professional 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 for you.
Christian sharing plans like Samaritan Ministries (Classic), Liberty HealthShare, Medi-Share, and Christian Healthcare Ministries (Gold) generally cover our care almost 100%. We 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.
Verify Your Insurance Benefits
The first step in obtaining optimum reimbursement from an insurance company is the verification of benefits. The process takes about a week to complete. You will receive a response via email from Larsen Billing Service, and we will follow up with you to answer your questions. If you have insurance, you will be required to register with Larsen Billing Service prior to your first visit. If you have not registered with Larsen Billing, we will consider you to be self-pay, and you will need to pay for your care at the time of service.
If you have a Samaritan Ministries Classic or Christian Health Ministries sharing plan, you do not need to do the insurance verification through Larsen Billing.
To verify your benefits, complete and submit the Patient Registration Form. For Winchester, your Provider’s PIN is: 14137. For Chantilly, your Provider's PIN is 19760. If you're undecided, you may use either PIN.
Larsen Billing Service charges $20 to verify your insurance. If you have a Medicaid plan, there is no charge to register with Larsen.
Anthem Blue Cross Blue Shield
Tricare - Military Health Insurance
Christian Healthcare Ministries