Yes, you can receive insurance reimbursement for your Vashon midwifery services! 

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*Do not fill out a VOB if you are on Medicaid. Read more below.*

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MEDICAID - 

100% of your pregnancy, home birth, postpartum, and newborn care will be covered by your WA state Medicaid plan. We are specifically contracted with Molina for Medicaid. If you are on another Medicaid health plan, it is quite simple to change to Molina here. Vashon Island Midwifery manages all communications and billing for people on Medicaid. There are some out-of-pocket costs to consider when planning a home birth with Vashon Island Midwifery, including a birth assistant fee, a birth supplies kit, and a tub rental (optional).

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COMMERCIAL INSURANCE (not Medicaid)- 

All services provided through Vashon Island Midwifery are paid directly to the organization for midwifery services as a flat fee. The fee owed is based on a Sliding Scale model. We utilize the Green Bottle Method of determining the appropriate fee for service that a client is to pay for their care. This model is based on integrity and no proof of financial income is necessary. Our clients are financially responsible to pay Vashon Island Midwifery their flat fee by 37 weeks gestation; payment plans are welcome. Accepted payment methods include cash, check, cc, gift card (available through our website), or HSA/FSA funds. As a small, island healthcare practice, Vashon Island Midwifery is not able to manage any commercial insurance communication and/or billing at this time. However, we are partnered with an incredible team of billing specialists who will work with your insurance and are dedicated to obtaining the highest level of reimbursement for you.

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FAQs:

• But other healthcare providers do my insurance billing for me, why doesn't Vashon Island Midwifery?

  • When we first opened our practice, our midwives were doing all the billing for our clients. However, this proved to be very expensive and time-consuming, and we felt it took away from our ability to do our job well as your midwife! Switching to a prompt pay, or flat fee process allows us to keep our doors open and provide exceptional, personalized care. Our sliding scale model makes sure that our services are still affordable to everyone and our billing partners ensure that you can be reimbursed for the care you received and paid for upfront.

• How much will my insurance pay me back?

  • The short answer is we don’t know. Billing insurance is based on services rendered and we won’t know what exactly we can bill until after the delivery. The other factor is that your insurance company’s allowable amount for each service will vary. An insurance company may say they cover a certain percentage, but that percentage is based on their allowable amount, not the amount your midwife is charging or what our billing specialists submit on an insurance claim.​

• Are services billed as in-network or out-of-network? 

  • Vashon Island Midwifery is considered an out-of-network provider, HOWEVER, our billing specialists are very experienced at getting our clients gap extensions. ​Gap Exceptions, Network Exceptions, PPO Waivers, Single Case Agreements, or Letters of Agreement all have similar meanings. The terminology varies depending on the company and the plan. But all of them are ways of getting the provider covered at the in-network level. Getting a gap extension typically means better reimbursement and means your midwifery care will count towards your in-network deductible/benefits.

• Do I have to pay the billing specialists for their service?

  • Birth Professional Billing charges the client 10% of the insurance reimbursement to manage all of their gap extensions, claim submissions, communication with insurance, etc. This means if you receive $0 from your insurance, you owe the billers $0. This incentivizes the billing specialists to work hard to help you achieve the highest reimbursement possible. There are no fees for filling out a Verification of Benefits form (see below). Our billing specialists are available to you for direct communication and any questions you may have about insurance reimbursement. They will manage the entire insurance reimbursement process on your behalf.

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Verify your insurance benefits by clicking on the link below. You can file a VOB with Birth Professional Billing before or after initiating care with Vashon Island Midwifery.

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For questions about insurance reimbursement, please email Birth Professional Billing here.

 

For all general questions, questions about  or questions about the Sliding Scale process, please email Vashon Island Midwifery here.

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