Q: HOW IS MIDWIVES ADVANTAGE DIFFERENT?
Midwives Advantage is a corporation established to get midwives paid through insurance. We have midwives in 38 states and have better collective bargaining powers than an individual practitioner. Healthcare providers become contracted employee providers of our corporation; therefore, claims process through our corporate agreements. Claims are billed using the corporate tax ID numbers, not the midwife’s social security number or EIN. We process millions of dollars in claims each year, and as a result, we have a better position with the payers than an individual practitioner or a birth center.
Q: WHAT ADVANTAGE DOes MIDWIVES ADVANTAGE give me?
Claims submitted through our company are billed at nationally recognized rates; therefore, midwives enjoy being paid at a higher rate. We submit over 20 million dollars in claims every year and have more bargaining power as a group. The healthcare provider is responsible to accurately report services provided but not personally responsible for the way claims are submitted. Midwives can focus on providing patient care; instead of learning coding and billing.
Q: CAN PROVIDERS CHARGE DIFFERENT PRICES for cash pay and insurance patients?
Laws vary from state-to-state, but generally, the answer is yes. In-network providers agree to charge cash pay and insurance clients the same rate; however, if you do not have a contract, you can use a different fee schedule for clients with varying circumstances. Healthcare practitioners can offer a pre-payment discount. This practice is similar to negotiating a discount with insurance payers.
Q: WHAT ARE STANDARDS FOR DOCUMENTATION OF HEALTHCARE SERVICES?
Medical record documentation standards are established on state and federal levels for professionals that provide health care services. Documentation records need to be legible and chronological. Documentation is required to submit claims.
Q: ARE THERE ANY PAYERS TO WHOM YOU DON'T SUBMIT CLAIMS?
We do not submit Medicaid, Medicare, or Tricare.
Q: Can I FILE CLAIMS WITH BCBS?
BCBS claims pay as long as the plan allows for out-of-network services and maternity care.
Q: How do Providers get paid for claims?
The insurance company sends payment to our corporate offices, we deduct our fees and send the balance to the provider through direct deposit. Payroll is processed every two weeks and funds are deposited into the provider's account on Friday. A spreadsheet of all payments is posted in Basecamp so the midwife is aware which claims have processed.
Q: WHO IS RESPONSIBLE FOR THE CODES ON THE CLAIMS?
A: The biller, not the healthcare provider, is responsible to make sure all billable codes in the health record are submitted accurately on claims.
Q: CAN A PAYER COME BACK ON A MIDWIFE AND DEMAND MONEY FOR CLAIMS PREVIOUSLY PAID?
Payments are made to the corporation. This structure allows our legal department, instead of the individual provider, to communicate with the payer on refund requests. We do not refund money to payers on legitimate claims.
Q: CAN AN INSURANCE COMPANY REVERSE A PAYMENT?
Insurance companies occasionaly request a refund after a claim has paid. We have a legal department that responds to all request for refunds. If services were rendered and billed correctly, our financial department sends the payer a written denial to the request for a refund.
Q: HOW DO I GET STARTED?
- Schedule a call for a brief overview of our company.
- You will receive a log in to a secured page on our site and have access to our contract and sign-on information.
- Onboarding a new provider to our systems takes about two days. After onboarding is complete, you can submit claims.
Q: CAN I FILE FOR BIRTHS THAT HAVE ALREADY OCCURRED?
Midwives can file claims for the previous 12 months. This allows midwives to get paid for services when the client still has an outstanding balance. It also allows the midwife to reimburse clients that have paid for services out-of-pocket! It is a risk-free way to test-drive our services!
Q: can my clients have their insurance benefits verified before starting care?
Yes, your clients from the last year as well as clients that have not delivered yet can send their insurance information to us to be verified. This link take them to the Verify Insurance Benefit form. Ask them to select the claims manager that has been assigned to your account, so their request goes directly to your manager.
Q: How long does it take for a midwife to complete a claim form?
Claims can be completed in about ten minutes.
Q: Can i submit a claim for an intrapartum transfer?
If the midwife attended the patient during labor and transferred to a hospital for the delivery, a professional claim will be submitted for the services provided and a facility claim will be submitted to cover labor management and supplies used during evaluation and management.
WHAT MIDWIVES HAVE TO SAY
We were paid quickly and our clients were able to finance their birth with my practice through insurance. Thank You Midwives Advantage!"
"I've used all the billers for my claims! Midwives Advantage is definitely the best!"
"At first, I thought this was too good to be true but decided to give it a try. I really couldn't see that I had anything to lose by submitting a few claims from births that I'd already done. My clients were all for it! I got my first payment a month later, and I've never looked back. I really can't thank you enough for all you've done for my clients and me. It is such a relief to have a solution to offer my clients that have insurance!"
"This company is one of those things in life that almost seems too good to be true! I've been with Midwives Advantage for six years, and although they've had some struggles with some payers, I can say they never stopped working on claims. These women don't stop. They are constantly improving. I've seen a lot of changes over the years, and it just continues to amaze me. I am so happy to be able to give care to my clients and know I have responsive experts handling the insurance claims. Thank you for all you've done, and you continue to do for midwives!"
"My midwife emailed me and told me about Midwives Advantage. I submitted my insurance information, and she submitted the information for my claims. Imagine my surprise when all the claims were paid within 30 days! This was my fourth home birth with the same insurance and the only one that my insurance paid for! What your company is doing for the birth community is amazing. You guys are worth your weight in gold! Thank you!"
"I've used all the billers for my claims! Midwives Advantage is definitely the best!"
"At first, I thought this was too good to be true but decided to give it a try. I really couldn't see that I had anything to lose by submitting a few claims from births that I'd already done. My clients were all for it! I got my first payment a month later, and I've never looked back. I really can't thank you enough for all you've done for my clients and me. It is such a relief to have a solution to offer my clients that have insurance!"
"This company is one of those things in life that almost seems too good to be true! I've been with Midwives Advantage for six years, and although they've had some struggles with some payers, I can say they never stopped working on claims. These women don't stop. They are constantly improving. I've seen a lot of changes over the years, and it just continues to amaze me. I am so happy to be able to give care to my clients and know I have responsive experts handling the insurance claims. Thank you for all you've done, and you continue to do for midwives!"
"My midwife emailed me and told me about Midwives Advantage. I submitted my insurance information, and she submitted the information for my claims. Imagine my surprise when all the claims were paid within 30 days! This was my fourth home birth with the same insurance and the only one that my insurance paid for! What your company is doing for the birth community is amazing. You guys are worth your weight in gold! Thank you!"
