Fees

"And you guys are with every penny of it! Honestly when I first looked into you guys I couldn't believe how low your prices were." Logansport Mom

"I've always said it is true that you get what you pay for, but I would happily have paid double for all that we received with Believe Midwifery! You are the best!!" Indianapolis Couple

"Wow. Hiring a comedian for a single event is $1,500 to $3,000. I can't believe you can offer all the care you do at such low rates! Your fees are less than a semester of college and we get so much more than 12 credits!" Indianapolis Father

The package fee for standard prenatal care and delivery is $5,000. Payment paid in full within 30 days of your first prenatal visit offers an early payment discount, for a total fee of $4,200; otherwise the total package fee and any additional expenses incurred must be paid at the beginning of your 36th week of pregnancy.

Clients that pay in full, prior to their thirty-sixth week of pregnancy are offered a maternity package that includes:

• An initial consultation with the CNM including health history review and complete physical exam;
• Standard prenatal care, including monthly visits through your thirty-sixth week of pregnancy, and bi-weekly through term, then twice each week for the duration of the pregnancy;
• Attendance within our Optimizing Pregnancy, Labor & Birth, Breastfeeding, & Early Parenting Classes offered each quarter;
• 24/7 CNM phone availability for emergencies throughout pregnancy;
• Home risk assessment at or around thirty-six weeks of pregnancy by a member of the midwifery team;
• Travel expenses for the CNM and assistants;
• Labor management and home birth care by the CNM and midwifery assistant/s;
• Birth supply kit;
• Emergency management of mother or baby, as appropriate, including transfer of care to a medical facility during an intrapartum event and postpartum/newborn care through three hours of age;
• Newborn exam and immediate post-partum care for mother by the CNM and midwifery assistant/s;
• Home visit during the first week for both mother and baby;
• Obtaining the newborn metabolic screening (lab fee is separate);
• Filing of the birth certificate and newborn's social security card (paternity affidavit if appropriate); and
• Postpartum office visit for mother at six weeks (labs additional).

Each client is asked to pay $240 (plus lab expenses) at the initial office visit. For clients who decline the early payment option, we require a minimum payment of $175 per visit (plus lab expenses) with entire fee of $5,000 due prior to the 36th week of pregnancy. Other payment options maybe arranged per the discretion of the CNM; however, these must be agreed upon prior to the initiation of care.

Childbirth Education & Lending Library

Clients who have never birthed at home are asked (required) to seek an appropriate childbirth preparation course. Our practice offers a full childbirth education program FREE, with four classes in each series, on the third Saturday of each month from 11am to 3pm. Private in-home teaching sessions are available for those who are unable to commit to four Saturdays, for $265. Certainly it is not required that your course be from our practice; however, there are limited options for childbirth preparation specific to natural childbirth as 97% of all births occur within the very interventive hospital environment. Please discuss other childbirth preparation options with one of the Nurse Midwives.

Believe Midwifery Services, LLC has a rather extensive lending library, with books addressing well woman care, pregnancy, nutrition, birth, newborn care, breastfeeding, fitness, essential oils, herbs, homeopathy, massage, devotionals, anthropology, immunizations, circumcision, grief and depression support, even midwifery biographies and fictional stories of interest. Numerous DVDs are also available. The practice utilizes an on-line catalog database. If interested in becoming a member of our lending library, please e-mail Gretchen and a username and password will be provided.

Laboratory Fees & Ultrasounds

Believe Midwifery Services, LLC has secured a contract with a local laboratory and can offer exceptionally reduced fees to cash paying clients. Total maternity laboratory expenses typically range between $25 and $125. All testing will be mutually agreed upon by the Nurse Midwife and client. Medical insurance companies will be billed by the laboratory accordingly for those who are insured, although all clients are responsible for paying our venipuncture fee. Specimens will be obtained in the office by the Nurse Midwife, or if more convenient at a lab in your own neighborhood.

Ultrasounds can be obtained in several locations. The practice has secured significantly decreased cash prices in the Indianapolis area between $169 and $250. High level ultrasounds can also be offered with the Maternal Fetal Medicine specialists at St. Vincent Hospital. These fees are billed directly by and paid to those specific practices, independent of Believe Midwifery Services. Not all our clients opt for ultrasound imaging during their pregnancy.

Spa Rentals

Four spas are available for rent each month from Believe Midwifery Services, LLC, as an additional luxury for those that desire. Spas are reserved with payment of $300 in the order payment (and signed contract) is received. The practice also owns a professional LaBassine blow up tub, which can be rented for $150. The LaBassine rental includes essentially all the necessary equipment for use, and will be provided at your thirty-six week home risk assessment visit. Cleaning and removal will be provided by the midwifery team as part of your rental expense. For clients with limited financial resources, we have a non-professional LaBassine tub that was donated by one of our previous clients. This can be requested and is reserved on a first request basis.

Primary Newborn Care

Penny Lane MSN, CNM, IBCLC holds an undergraduate degree in maternal & child health; lactation consulting. Our team appreciates the first few weeks of mothering to be among the more challenging and vulnerable, particularly within a medical industry that has a history of sabotaging success. Penny is more than happy to continue care of the newborn through six weeks of age for those who desire; however, pediatric care beyond 48 hours is outside the standard maternity package.

For those that continue newborn care with the CNM: a copy of the newborn chart will be provided at the six week visit to share with your chosen pediatric provider. If pediatric care is not continued with the Nurse Midwife following the initial home visit, another pediatric provider must be secured prior to thirty-six weeks of gestation, so records can be transferred and sites for required state screenings can be identified. Prices for newborn care within our practice are:

• Two week office visit (30 minutes): $65
• Six week office visit (30 minutes): $65

Believe Midwifery Services, LLC is the only midwifery staff with a degree holding lactation consultant, IBCLC and number of CLCs on staff. We value breastfeeding success; therefore, we host a FREE Mother's Gathering Group the third Friday of each month, from Noon to 2pm, in the Thorntown office and encourage all mothers to attend for peer support.

Lactation consultations can be scheduled with Penny Lane MSN, CNM, IBCLC within the office, as well as frenotomies for tongue-tied babies. Please be aware, that the above newborn office visit allows for breastfeeding support, but not consultation for lactation challenges.

• Lactation Visit in the office (60 minutes): $175
• Lingual or Labial Frenotomy: $165

Believe Midwifery Services, LLC is the only homebirth midwifery practice offering all state mandated testings without need for outside referral. These include the newborn metabolic screening, newborn hearing screening, and pulse oximetry screening.

• State Required Newborn Screening: $85 (price of obtaining specimen included within maternity package)
• State Required Hearing Screening: $110 (offered at no additional expense to those who continue newborn care within our practice)
• Pulse Oximetry Screening: (currently offered at no additional expense)

Primary Care of Women throughout the Lifecycle

While catching babies certainly is our greatest passion, Nurse Midwives are also trained as primary health care providers for women of all ages. This not only includes annual exams, child-spacing options, pap and breast exams, but extends into management of chronic or acute conditions.

• Annual Visits for an Established* Client: $90 for an hour
• Annual Visits for a New Client: $140 for an hour
• Simple Pap and Breast for an Established* Client: $65 for thirty minutes
• Simple Problem Visit: $65 for thirty minutes
• IUD Placement: $140 placement fee, plus fee of IUD (ranging between $199 and $265)
• Raindrop Therapy: $95

* An established client is one who has had a full health history and head-to-toe exam within our practice, within the last three years.

Retail Boutique

Believe Midwifery Services, LLC offers a small retail boutique. Products are chosen for their holistic approach to wellness, environmentally conscious values, and high standards of manufacturing. Many items are available for advocacy efforts as well.

Believe Midwifery is a distributor of Hygeia breastfeeding pumps and accessories. Those concerned about the growing problem of baby products proliferating landfills will appreciate Hygeia pumps having FDA approval fo resale, eliminating the need to repurchase pumps after a single year's use as required with competing companies. The practice also offers a hospital-grade pump for monthly rental.

Essential oils and nutritional supplements, including probiotics, are available from Young Living Oils. Believe Midwifery Services, LLC places an order each month on th e9th, allowing clients to special order as they desire. Various herbal products, healthcare items, slings, and newborn accessories are also available in our boutique.

Invoicing for Reimbursement

All clients will be provided an invoice for services rendered at the end of each visit, which can be utilized for insurance reimbursement and/or HSA, FSA, or other tax-exempt accounts.

Payment is accepted in cash or by check, made out to Believe Midwifery Services, LLC. Visa, Discover, Master Card and American Express are also accepted.

Paula Miller MSN, RN assisting the entire family in cutting baby sister's umbilical cord. 

If you think hiring a professional is expensive, wait until you hear rates from the amateurs!!

We were invited into the Bureau of Better Business in 2010 and are currently ranked with an A.

Believe Midwifery Services, LLC has worked hard to obtain insurance reimbursement for our clients since it's opening in 1997. However, their increased demands and decreased payment has meant we are extending far too much effort for minimal return and our clients are increasingly becoming frustrated with the process. Because not all clients are able to discern their frustration as that caused by their insurance company, rather than our practice, we need to pull ourselves out of the equation. We are midwives and our primary objective is to provide excellent healthcare.

It is with regret that we can no longer accept insurance from any source. We will however, provide an invoice for services provided so clients can file a claim with their insurance provider and recoop some of their expenses. As well, we are working to secure a consultant that can be hired by clients interested in utilizing her billing and coding expertise to maximize your return.

Those employed at Wabash College on the Cigna plan, please read below.

Many insurance companies do cover the professional services provided by Penny; however, reimbursement rates are dropping significantly and additional clauses are being added to plans that exclude birth outside the hospital. While the vast majority of plans offered in-network exceptions just a year ago, many of those same plans will not even cover maternity care at the out-of-network rate today.

Please understand that insurance companies define global maternity care as 4-7 prenatal visits, attendance by the MD or CNM for one hour at the birth, and the mother's six week postpartum visit. Payment for labor support, fetal monitoring, attendance by nursing staff at the birth, medications, suturing, newborn screenings, birth equipment, newborn assessment and on-going care including home visits is often part of the facility fee, which Believe Midwifery is unable to bill for because Indiana does not recognize the home as a birthing facility. (Send your complaints to the Insurance Commissioner to rectify this issue.)

For this reason, our $5,000 global fee is determined by some insurance companies to be higher than the standard usual and customary fee for the global maternity package. The usual and customary fee for many Anthem plans is as low as $1,870.

As an insurance holder seeking care, you are responsible for the co-insurance fee for all itemized services outside your global. One might assume 100% coverage means all their bills would be paid, but in reality, the insurance plan will pay only 100% of what they approve (which is inconsistent and exceptionally minimal). Quickly unpaid claims escalate and because we are only allowed to offer reduced fees for early payment, the insured client is then responsible for the exoborant fees unpaid by their insurance company. Becoming a cash client is indeed the most cost effect option and certainly allows our staff to focus on clinical needs, rather than arguing with insurance companies.

Cigna Plan through Wabash College

While we require payment in full prior to services, Wabash College has sought an In-Network exception with Cigna for their employees to be seen by Penny Lane for maternity services. They agree that care provided by our practice is both of high quality and is cost-effective, and therefore, want to extend this benefit to their staff. This does not include well woman care, although if an employee were so inclided, I am sure the human resource director would make this exception as well.

Achieving this success was fairly uncomplicated. One of our proactive mothers spoke with her human resource department, respectfully shared her desire for the midwifery-model-of-care and homebirth services and why this would benefit her employer. The HR director agreed and within only a few days the contract between Wabash College and Cigna was up-dated to include this in-network exception. We encourage you to do the same with your own employer.



16 percent of health insurance claims are denied on the first try

A report by the Government Accountability Office suggests that UP TO 50 PERCENT of patient appeals prompt insurance companies to reverse their denials. Once you rule out clerical error on your claim, start the appeal process by writing a letter to your insurer that states why you're challenging the decision. Go here for more on filing an appeal, or read below for form letters that might be useful to your case. 

Academic OBGYN offers an argument in effort to persuade insurance companies to cover the services provided by lactation consultants.

If your insurance company states they do not cover Nurse Midwives or homebirth, this is typically less to do with your insurance company and more to do with the contract signed by your employer's Human Resource Department. We have had great success with clients approaching their employer and encouraging them to address these barriers to midwifery care. This letter may be of help to you if CNMs are not covered, and this letter can help you appeal a denied in-network exception. I would encourage you to read both, as each can be adjusted to suit your needs. Clients have also argued denials based on the decision that other providers in their area do not provide homebirth services and for that reason the requested exceptions were approved. Most recently however, we have had denied claims or in-network exceptions based soley on homebirth not being "medically necessary." We are creating a letter to address this argument as well, and will share as soon as it is available.

Please forward your letters to the movers and shakers in our state. Help other families benefit from your work.

Send copies of your letter to your legislative leaders, the Indiana Insurance Commissioner (see below), the Attorney General (see below), your employers Human Resource Department and to your midwives. Finally, the Health Finance Commission is the General Assembly that has reviewed midwifery bills for the last several years. It would be very beneficial if they could be made aware of issues facing homebirth families.

The Indiana Department of Insurance office is located at 311 West Washington Street, Suite 300, Indianapolis, IN, 46204.  The main telephone number is (317) 232-2385.

Indiana Attorney General's Office
Indiana Government Center South
302 W. Washington St., 5th Floor 
Indianapolis, IN 46204
Phone: 317.232.6201
Fax: 317.232.7979
E-mail: Constituent@atg.in.gov

The average uncomplicated vaginal birth costs 68% less in a home than in a hospital, and births initiated in the home offer a lower combined rate of intrapartum and neonatal mortality and a lower incidence of cesarean delivery.

Journal of Nurse-Midwifery. 44(1):30-5, 1999 Jan-Feb.

Indiana Medicaid

Although Believe Midwifery Services was an active participant in each of the Indiana Medicaid plans for a few years, unfortunately a clerical error by the Indiana Medicaid program terminated our practice without our knowledge for many months, and subsequently caused a large majority of our Medicaid claims for the years of 2010 and 2011 to be denied. Although one would think this would be easily rectified since all parties recognize the error as the fault of the state, we have not received such grace. Believe Midwifery Services simply could not invest the time and money required to recoup our losses, determining the most cost effect approach to write off those debts and discontinue the Medicaid program.

If you do qualify for the Medicaid program however, it will most certainly cover your ultrasound and laboratory testing, and in the event you would choose to or otherwise risk out of our practice, Medicaid would cover those expenses outside our care.

We have absolutely no desire to return to the Medicaid program.