Insurance Topics--We are under construction and working to get all the links active. We will be adding to our resources regularly, so please visit us often.
General Interest
Insurance Commissioner—Find the Office of Insurance Commissioner for your state. This is where you can ask specific questions regarding your state statutes and laws, also send complaints regarding insurance companies and their reimbursement practices.
Insurance Code by State—The entire code, searchable by state.
NPI Application—As of 2007, all providers must have a National Provider Number in order to submit claims to insurance carriers. It takes about 10 minutes to fill out the application form and your number is emailed to you within about two minutes.
NPI Registry—this allows you to search for any provider’s NPI number and is updated daily.
APN Power Point presentation—research demonstrating the impact of Advanced Practice Nurses on quality, satisfaction and cost savings created by the Ohio Association of Advanced Practice Nurses. This includes Certified Nurse Midwives and is an excellent presentation for policy makers at insurance companies. Click here for the one-page synopsis of the power point presentation created for employers.
DOH Cost Study—A study conducted to determine the economic costs and benefits of the practice of licensed midwifery. The conclusion states an estimated cost savings to the health care system (public and private) of $2.7 million in Washington State alone. This is a great study to present to Medicaid programs and other insurance companies on demonstrate how midwives save money.
Insurance Billing
AquaDoula-- Birth & Beyond in Seattle, WA has created this one-page letter directed to insurance carriers explaining the use of a birth tub for pain relief.
CLIA Certification—If you are billing for any lab work, including routine urine dips and pregnancy tests, you need a CLIA certificate. Many insurance companies will request your CLIA number when submitting claims for lab work.
Insurance Fraud--What is it and how does it affect midwives?
Place of Service Codes--What is the definition of 11, 12, 21 and 25, anyway? Read the CMS definitions here.
Working with the Employer's HR Department--Step by step instructions on how to use the HR department to obtain coverage for midwifery care.
Insurance Coding