Financial Considerations

General Information About Your Care

Treasure Valley Midwives provides maternity care, newborn care up to six weeks, well-woman care and limited primary care to women in all stages of life. We offer insurance billing services and also happily accept clients without insurance. Treasure Valley Midwives is currently accepting Medicaid clients and is an in-network provider for the IPN network, which includes Pacific Source, Cigna, TriCare Standard, Aetna, as well as others.  Additionally, we are in-network for Blue Cross of Idaho, United Healthcare, Bright Path, and St. Luke’s Health Partners, which includes Mountain Health Co-Op, Providence, Regence (PPO/Traditional), and SelectHealth* (Commercial & MA).  Some payors have national contracts that supersede the network for certain provider types.

Components of Your Care

  • Global Maternity Care refers to routine maternity care including prenatal care, delivery and routine postpartum care
  • Homebirth Fee refers to attendance at your home birth by the traveling midwifery team
  • Facility Fee refers to admission and care provided at the birth center birth

Please call for basic cost information and breakdown of benefits

 

Other Charges

Labwork, Ultrasound, Newborn care, primary care, any referred services, non-routine lactation care, prescribed medications, vitamins and herbs are not included in Global Maternity Care, Homebirth Fee or Facility Fee. These items are charged separately.

Discount

For clients who are paying out of pocket for their care with no insurance billing we offer a discount on the Global Maternity Care fee. The cash discount is 10% when paid at your first visit.

At-a-distance Clients

Our local area is within 30 miles of the birth center. Clients who live beyond 30 miles will be charged a mileage fee. We will use a mileage worksheet to determine the mileage fee.

Payment Considerations

Payment for the Global Maternity Care, Homebirth Fee or Facility Fee and Newborn Exam are expected to be paid in full by 32 weeks of pregnancy. Other charges are expected at the time of service.

We will provide you with a worksheet showing your estimated out-of-pocket expenses with a breakdown of payment options meeting our 32 week payment requirement.

General Information About Health Insurance

  • Treasure Valley Midwives currently contracted with Medicaid and other insurance companies (see above).
  • There is almost always some level of coverage for our care as part of your out-of-network maternity benefits.
  • We will bill your insurance for your newborn care, newborn must be added to your policy according to the contract time allowance that you have with your insurance carrier.
  • Insurance plans typically have a deductible and coinsurance that the client is responsible for paying.
  • Your insurance plan determines the amount that the insurance company will pay for your care. Sometimes the amount that your insurance plan is willing to pay (the ‘allowable amount’) is less than the amount that is billed for your care.
  • The State of Idaho does not license freestanding birth centers. Insurance plans will often not cover the facility fee for unlicensed facilities. Insurance plans also will typically not reimburse the homebirth fee.
  • Your estimated out-of-pocket expense is based on Global Maternity charges, your deductible, your coinsurance, the Facility Fee or Homebirth Fee.
    For example: You are choosing a birth center birth and have an insurance plan that has a $500 deductible and then pays 70% after the deductible has been met. Your coinsurance is 30% (actual contracted allowed amounts will vary by insurance provider)

    • Global Maternity charge is $3000. You pay the deductible of $500 leaving a difference of $2500.
    • You are responsible for 30% of the difference or $750.
    • Your estimated out-of-pocket expense for your insurance plan is $1250 (deductible of $500 + coinsurance of $750).
    • You are responsible for the Facility Fee of $1500 . Your total estimated out-of-pocket expense is $2750 (Deductible + Coinsurance + Facility Fee).
    • Your insurance plans allowable amount for our fees may be less than what we charge. You will be balance billed for any unpaid portions of your care if you are out of network only.
    • Even though insurance plans rarely reimburse our facility fee and homebirth fee we will bill them anyway. If they pay on those claims we are happy to refund you based on the payment amount.

If you have insurance and decide to use it, please remember that your insurance coverage is an agreement between you and the insurance company. We will not be able to answer questions about expenses associated with your insurance plan.

Other Information

  • You will be provided with a fee schedule with the most common charges. The front desk staff is available to answer any financial you questions you may have.
  • If you have to transfer out of care for any reason during your pregnancy you will only be charged for the care you received. We will use the fee schedule to determine your balance or refund. (Refer to Financial Agreement and Fee Schedule for complete details)
  • All clients are required to complete a Financial Agreement, a Payment Plan and a Mileage Worksheet if applicable. Worksheets will be provided in order to determine your out-of-pocket expenses and a payment plan that works for you.
  • A non-refundable deposit of $250 is expected at your first visit and will be applied to your out-of-pocket expenses.

This information is not meant to capture all costs or agreements associated with your care. The front desk staff is available to answer any financial questions at any point before, after or during your care. Refer to the actual Financial Agreement for complete information.