Why We Have a Cash-Pay System
To focus on a care-based model and minimize costs, we adhere to an exclusively cash-pay* system. This means that all fees are due at the time of service, with homebirth service fees required prior to birth as outlined in the financial services agreement. This approach eliminates the complex billing associated with insurance coding, fostering a more spontaneous and personalized interaction between us. Additionally, it simplifies documentation for appointments, treatment notes, and progress records.
*Despite the term “cash-pay,” our payment options extend beyond cash to include check, credit card, HSA, FSA, and even health share plans.
In short: it ensures that our focus remains on YOU and your care, rather than insurance-driven criteria.
The Trouble of Dealing with Insurance
Navigating the complexities of insurance billing can be daunting. Typically, care providers assign CPT codes to medical services, a system fraught with intricacies of "timed codes" and "untimed codes." This is a time intensive and often confusing billing system, as the amounts billed to insurance vary based on the length of a visit, and the specific services provided on a given day.
Cash-based billing eliminates this complexity, allowing us to build a more personal connection together. Documentation, treatment notes, and progress records become more streamlined, and is authentic to the care that the we provide, rather than to the satisfaction of an insurance company.
As an independent, certified professional midwife practicing in an unregulated state on a cash-pay system, I'm not beholden to insurance or any legal requirements in the Commonwealth of Pennsylvania. Adhering to these things is time consuming and detracts from the care I wish to provide you. In addition, accepting insurance would create more costs. By avoiding third-party billing services or insurance representatives, we cut out-of-pocket expenses significantly.
How you can possibly still utilize your insurance
You might still be able to use your insurance for "out of network" reimbursements. Opting for an "out of network" provider allows you to receive services from a non-participating care provider (like us). You can seek reimbursement for fees paid to us by submitting paperwork to your insurance company. This process can be found on most insurance companies' websites.
It is very important to note that in these circumstances, you are not requesting that a claim be paid, but are seeking reimbursement for fees paid to an out of network provider.
I’ll say it again: It’s a reimbursement, NOT a claim.
We are unable to discuss reimbursements with insurance companies. Upon completion of our services, we will provide you with an invoice that you may submit along with your receipt of payment to your insurance company for reimbursement.
Please note that this information pertains to midwifery service fees, homebirth fees, and wellness visits. All lab fees are processed through LabCorp and may be billed to insurance separately. Additionally, all ultrasound fees are payable to the third-party ultrasound provider of your choice.
We're committed to transparency and providing you with the most comprehensive care. If you have any questions or seek further clarification, please ask at your next appointment.