Pay a professional midwifery biller to contact your insurance and verify the details of your benefits. They know what questions to ask.

1. I recommend Maggie at Napier Midwifery Billing

2. She emails you your insurance benefits, with guidance

Understanding what your out-of-network benefits are can also guide whether you pay for labs or ultrasounds with cash pay discounts or have them billed to your insurance.

If you can, you should apply to your insurance to consider your homebirth for in-network status through the loophole that if there are no local in-network providers offering that service, then they should allow your claim by an out-of-network provider to be applied to your in-network deductible.

Some PPOs require a referral letter from an in-network provider, like your primary care doctor. Since I am a CNM, they are referring to a licensed provider, which helps your case.

In your insurance portal you will upload a superbill or claim form completed either by me or by the biller. In the past, the billing claims could not be submitted until after birth. Starting in 2027, we must itemize all components of care on claims so it may be possible to submit claims before birth- TBS.

Insurance companies decide what they will pay for any given service code.

Examples: If they determine it is worth $4000 and your deductible is $5000 then your claim just "applies to your deductible." If your deductible has been met, then you receive the $4000.

Your insurance company issues a check to you for the determined claim amount.