Streamlined Doula and Midwife Billing for Faster Claims Processing and Better Financial Outcomes

Yes, we exclusively handle billing for Certified Nurse Midwives, licensed midwives and direct entry midwives including Medicaid and commercial claims, prenatal bundling, delivery coding and postpartum reimbursement accuracy.

We accept Medicaid and some commercial insurance plans; reimbursements are contingent upon state Medicaid programs and specific commercial plans, and we will verify eligibility and submit claims in accordance with accepted Medicaid codes and follow the guidelines of the commercial plan to ensure that claims are accepted.

Yes, midwives need to be enrolled in a scope of practice separate from physicians, and a scope of practice is required for each Medicaid and commercial payer; we apply, renew, and verify scope of practice for midwives to ensure that application-related claim rejections don't occur.

Midwifery care is frequently lumped together in the wrong billable codes and we split up antepartum visits, delivery service and postpartum care into separate billable codes so practices aren't undercompensated for their services.

Denials are often due to incorrect modifiers, missing supervising physician documentation or scope-of-practice issues; we are aware of these and make corrections and appeal denied midwifery and doula claims.

Yes, we do accept facility fees, midwife professional fees, and the coordination of claims for freestanding birth centers, and we are able to interface with the payers and ensure that both the facility and the provider fees are accurate and in line with their requirement.

Medicaid regulations differ from state to state on what services are covered, reimbursements, and documentation; we keep up-to-date on these differences to ensure claims are compliant and filed for payment.

Doula billing utilizes state Medicaid codes and HCPCS codes as applicable and follows patient care guidelines as outlined in the payer policy to ensure proper reimbursement for patient care provided by the doula.

Our collections, denial trends, and payer turnaround tracking includes tracking for denials and payer turnaround specifically for maternity and midwifery claims, helping practices see how doulas and midwives are doing in billing every month.

Our team is well-versed in the rules and guidelines of midwifery scope of practice, the complexities of doula coverage, and maternity bundling, ensuring practices don't have to deal with denials and get correct reimbursement for every birth-related claim.