
Standard Midwifery Fees
We value our appointments not only for educating, caring and walking along side you in your care, but also as a time to build a relationship. We value quality care for each mom/baby and therefore, limit our clientele to a number we can properly and adequately manage and balance with our busy lives. Quality! We could take more clients each month to lower our fees, but quality would suffer. We seek to find a balance in fees and quality! This is our focus word. Please contact us for a free consultation to discuss my midwifery care with you. We would like you to see the difference in care offered to traditional care. We don't surprise you with hidden fees later in your care.
What your care includes:
-
Appointments: consultation, 9-12 pre-natals: 30-minute allotted time - 3 times the time spent with most doctors. 3 post-partum appointments for mom, 3 post-partum appointments for baby (these are from 30-60 minute appointments, sometimes longer). Appointments that respect your time and try to keep your waiting room time to a minimum.
-
Labs: initial labs (state required stds, A1c, Iron levels, Blood typing and antigen testing, titers. I also run many labs for health that you do not get in a doctor's office as standard. Ferritin, Vitamin D, Vitamin B-12, Thyroid, and Folate levels), 28-week labs (glucose testing including organic tapioca dextrose for testing, Iron, and Metabolic panel, antigens for RH neg mothers) 36-week testing (retests many of previous tests and adds GBS testing), PLUS any testing we deem necessary eg: rechecking iron, liver, urine, vitamin D or other testing. There is optional testing available at an additional cost.
-
Setting up and maintaining charts and records: This is keeping records, labs, notes from conversations during the week, requests for records, releases for work or medical treatment, making appointments and managing payments.
-
On Call access 24 hours a day for emergency/critical situations, labor support and other situations that need 24 hour care. 5 day access for non-emergent needs. You get us - not an answering service or tele-nurse.
-
A midwife remaining local for full term mothers. We stay in town for you! It is important that either Bri or I are at your birth if it is in our ability to do so. There is always one of us local.
-
Extra appointments or time spent driving to home-births, 2 day visits or office for prodromal labor and labor progress checks as well as heartbeat, ruptured membranes or other situations that may need an evaluation. You are not sent to the ER for non-emergency care. We come 24/7 if the situation requires it.
-
Birth supplies needed at the homebirth
-
Tub rental, liners, nets for waterbirths at home or the birth center
-
Trained assistant or senior apprentice, or both. We always plan to have two trained people at a birth.
-
Labor monitoring and care, (average time is usually 4-6 hours, though it is not uncommon to spend up to and over 24 hours)
-
Labor support including positioning, comfort measures, birth balls, tens units, counter pressure, training your birth support team as able without diminishing quality of midwifery trained care. Hiring a doula is highly recommended, especially in your first birth for the ability to have more hands-on comfort care.
-
Birth - monitoring you and your baby for anything that would be considered a higher risk, including vitals, heart tones, labor patterns, exhaustion, shoulder dystocia, hemorrhage, and placenta management. Administering medications if necessary.
-
IV including IV antibiotics if needed
-
Suturing if needed
-
A minimum of 2 hours immediate post-partum management for mom and baby.
-
Rhogam shots for RH negative moms if desired
-
Breastfeeding support within the training of each individual midwife
-
PKU or newborn screen performed at 2 day and 2 week for baby
-
CCHD (Heart defect) screening at 2 day appointment
-
Vitamin K oral or injection, if desired
-
Erythromycin if desired
-
Access to our lending library
-
Driving time to your homebirth
-
Working with insurance biller to file your insurance, if necessary
-
Collaborating your care with other providers or referrals if it becomes necessary
-
Filing birth certificate
-
Labor support if you transfer to the hospital if desired.
-
Classes - which may include nutrition, exercises, breastfeeding, mental health, labor support and education. Taught by counselors, nutritionists, physical therapists and other who are knowledgeable in their field.
The prepaid $5500 birth fee is a discounted global midwifery fee which is comparable to the area. If we itemize each individual item. It would be between $6500 to over $7500. It must be paid in full by 36 weeks. This fee covers a lot!! And it gives a lot of quality individual care. It is often less than deductibles and copays.
The prepaid birth center fee is $1000 paid by 36 weeks paid in addition to the midwifery fee. The birth center fee is for any client desiring to use the facility with any midwife that has privileges to the facility. This fee is what enables the birth center to stay open.
Items that our not covered in our Standard Midwifery Package:
-
Ultrasounds - paid directly to the sonographer. $250 for a diagnostic ultrasound at 18-20 weeks. Other ultrasounds if there is a concern. Sometimes insurance or medicaid will cover these
-
Elective labs
-
Placenta encapsulation/tincture
-
Supplements
Can I transfer care to you at the end of care and pay less?
We love being able to offer the ability for women choose a different provider even up to birth. We do limit the number of clients we take each month. So late transfers would only be taken if there is availability. However, the majority of care happens after 36 weeks. Roughly 9 appointments occur before 36 weeks. An average of 7-10 appointments for mom and 3 appointments for baby occur in the last month and post-partum. Birth kit supplies and waterbirth expenses are incurred. An average of 6-8 hours of labor (sometimes over 24 hours), often times prodromal labor and postpartum care and clean up. Assistant fees. Birth and 2-day appointments also incur extra driving times. These appointments also take a longer time. The time spent in filing the birth certificate is also post-partum. In addition to this, we are playing catch-up on building a relationship which is so vital for birth. This is the part of quality care that suffers in a late transfer. Also, we are requesting records, doing additional charting and reviewing records which need to be entered in our system. However, with that being said, we do offer small discounts for previous care. An initial payment will be required, and auto-debit payment plan may be discussed at your consultation. Please we always encourage a free consultation to discuss your situation.
How is payment expected?
We would like a $400 payment on initial visit. Referring to monthly expenses listed above, we do request a monthly payment is made. We try to offer leniency and work with you, so that you may use healthshare accounts, bonuses, tax returns etc. Payment is required in full by 36 weeks.
Do you take insurance?
Yes, but we are not in-network with anyone and not every insurance pays us. Maggie with Napiermidwiferybilling.com will file your insurance. For a $25 fee, she will check your insurance to see what your coverage is. She is amazing with dealing with insurance companies. If your insurance will cover midwives, she will discuss with you the options and benefits of filing in your situation. If appropriate, she will start an in-network exception to get the most out of your insurance. Some, but not all, will grant an in-network exception. She collects 10% of the money your insurance pays. This is the most reasonable billing fees I have ever seen. If insurance doesn't pay, she receives nothing, even if she has spent a lot of time working on your claim. If you deductible is too high to receive payment, she will file to apply your midwifery fee to the deductible for $100 if you desire.
With deductibles and co-pays, often our pre-paid price is cheaper than a hospital birth.
And to be honest --- lately insurance is awful!! I am sorry, blame the government LOL.
Do you accept Medicaid or Tri-Care?
No we are unable to accept these insurances at this time. Superior Medicaid will pay for ultrasounds though.
We understand insurance can be frustrating. You pay a lot for it. It should cover something as basic as the birth of a baby. We get frustrated for you. We also encourage people to look into Christian Health-share ministries or Samaritan Ministries.
If you have other insurance questions, we can discuss them at your consultation.