Now MEAC approved for 14 hours of CE!
This program is designed to take you from knowing nothing about insurance, to being able to bill your own claims for both professional and facility fees. Designed for midwives, it has also been helpful to professional billers who do not have experience with midwifery billing.
Due to the frequently changing nature of insurance information, Billing for Midwives is updated on a continuing basis. To support these updates, access is structured differently than our other courses:
- An initial fee covers a month of access to the course, which should be plenty of time to complete the material, pass the post-test, and print your MEAC CE certificate.
- Access beyond that month is available for $4.99 per month - this will give you continued access to all the course material, personalized help in the discussion area, and access to new sections and updated sections as they are added.
- Yes, you can cancel the extended access at any time! (Under My Account>Billing>Subscriptions)
- If you do not want the Extended Access, you may enroll under the 30 Day Access option, or the 1 Year Access option.
Check out the full details of the curriculum below, but here are the...
1. Define what ICD, POS, and CPT codes are, and when they should be used.
2. Describe the structure of where payment comes from, in what timeframe.
3. Define what services are included in CPT 59400 and what services may be billed in addition to CPT 59400.
4. Explain the legalities of how to structure discounts in a manner that is consistent with Federal regulations.
5. Explain the pros and cons of in-network vs out-of-network coverage.
6. Demonstrate how to perform a VOB and calculate an estimated client responsibility.
7. Explain the legalities of balance billing.
8. Explain when and why GAP Exceptions may or may not be benefial.
9. Explain how Section 2706 of the ACA is helpful to midwives (yes, this is still in effect!).
10. Explain how other mandates may or may not be useful to midwives.
11. Demonstrate how to complete a CMS-1500.
This course has been approved by MEAC for 14 hours of continuing education, approval number M1920-101-0501DE, and this approval is current through May 15th, 2022.
This course was previously approved by MEAC for 10 hours of continuing education, approval number M1718-84-0425DE, from May 14th of 2018 to May 14th, 2020.
- About This Section
- New ICD-10 Codes for Covid-19
- Telehealth and Other Special Circumstances for Billing During Covid-19 Pandemic
- Coding for Telemedicine
- HIPAA Exceptions During Covid-19
- Links to Live Advanced Sessions
- Video: Intro and Overview
- Video: How To Get The Most Out Of This Class
- What is this?
- Video: The Three Problems
- Flat Fee vs Base Fee
- Video: What is a CPT code?
- Video: 59400 - Included or not?
- PDF: Inside and Outside Global Code 59400
- Video: Who pays what, when, and why?
- Do I have to charge my clients their portion?
- Video: The Solutions
- The Billing Revolution eBook
- BONUS SECTION: Basic Series Session #2 - Options and Legal Concerns for How to Structure Out-of-Network Insurance Reimbursement (with scenarios)
- Insurance Basics
- PDF: Glossary Of Insurance Definitions
- Resources Section for Health Care Sharing Ministries / Health Shares
- Resource Section for Health Saving Accounts and Flexible Spending Accounts
- Video: In or Out-Of-Network?
- Quiz: Ins and Outs
- Malpractice Insurance: Yay or Nay?
- Lawsuit Case Study #1
- Recommended Reading: How To Negotiate With A Liar
- IN Network Negotiation and RVUs
- NPI Q&A
- Fee Schedule Q&A
- Video: Is It Better To Be In or Out of Network? (same video as in Getting Started, Laying The Groundwork For Billing)
- Video: Live Session with Sizzly Auer on How to Become In-Net
- Common Requirements To Apply For Network Participation ("in-network")
- The Application Process
- Video: Q&A From The Live Session
- Recommended Reading: How To Negotiate With A Liar
- Video: VOB Basics - To Make That Call
- PDF Worksheet: Verification Of Benefits For Out-Of-Network Coverage
- Video: Billing For Midwives How To Calculate A Client Portion
- PDF Worksheet: Calculating An Estimated Client Portion for Out-Of-Network Providers
- Quiz: Calculating a Client Portion ~ Practice Time!
- Video: Who Pays What, When and Why?
- Understanding Allowed Amounts And Third-Party Negotiations
- Should I Ask if There is a Homebirth Exclusion?
- Do I Have To Charge My Client Their Portion?
- HFMA's Best Practices for Financial Interactions In Advance of Service
- Financial Agreement, Consent to Care, and Payment Collection Tips
- Skip Ahead, Then Back...
- The Legalities of Balance Billing
- Additional Reading
- Downloadable Template: Client Invoice, Pages Version
- Downloadable Template: Client Invoice, Word Version
- Mind The Gap! - Q&A From Discussion Area
- Articles & Request Letter Template
- PCP's Request for Exception
- Federal Mandate: Section 2706 of the Affordable Care Act (aka: ObamaCare)
- Class Action Lawsuit Against Healthnet
- Jesica's Request Letter During Pregnancy - Round 1
- Jesica's Request Letter - Round 2 - Success!
- Lauren's Successful 2706 (Post-Birth) Appeal Letter
- State Mandates: California, Florida, New Hampshire, New York, Vermont, and Washington (state).
- Federal Mandate: Newborns' and Mothers' Health Protection Act of 1996 (Newborn's Act)
- ICD-10 In A Nutshell
- PDF: Complete Tabular List of ICD-10 Codes for 2019
- CPT and ICD Grid
- ICD-10 Official Guidelines for Coding and Reporting, 2019
- ICD-10-CM Official Guidelines for Coding and Reporting, 2020
- PDF: Printable Quick Guide Z Codes Grid for Routine Pregnancy Care
- Predicting Trimester Specific Coding
- Non-Routine Pregnancy
- New Pregnancy Codes for 2019
- PDF: Printable Quick Guide Codes for Non-Routine Pregnancy Care
- Normal Birth, and General Birth Coding Rules
- The VBAC Dilemma
- Article: Delivering Accurate Coding Remains A Challenge (Part II)
- Special Circumstances During Labor and Birth
- PDF: Printable Quick Guide Codes for Codes for Labor and Birth
- PDF: Printable Quick Guide Codes for Codes for Postpartum
- PDF: Printable Quick Guide Codes for Newborns
- ICD-10 Updates for 2020
- Video: Place of Service (POS) Codes
- PDF: POS Chart
- Video: What is a CPT code?
- CPT and ICD Grid 2019 (same file as in ICD section)
- Video: What is included in the Global 59400? What is not?
- What about twins?
- PDF: Inside and Outside Global Code 59400
- Quiz: 59400 ~ Included or not?
- Q&A From Real Students: Global Billing
- Video: Visits In Addition To 59400
- Video: Time Based Billing
- Video: Venipuncture and Rh Immune Globulin
- Q&A: Troubleshooting Billing for RH Immune Globulin
- Video: ECV and NST
- PDF: Billing Beyond the Global: Pregnancy (eBook)
- Prenatal Care Q&A
- Video: Second Midwife/Routine Labor Assist
- Video: Second Midwife at a Shoulder Dystocia
- Video: Second Midwife at a Breech Birth
- The VBAC Dilemma (same video in ICD-10 section)
- Video: VBAC
- Video: In-Labor Transport (from home or birth center)
- Billing Beyond the Global: Labor, Birth, and Postpartum (eBook)
- Video: When can newborn care be billed in addition to 59400?
- Q&A: What about CPAP?
- Video: Routine Initial Stabilization by a Second Midwife
- Video: Newborn Resuscitation
- Video: Newborn Exam and Baby Visits
- Video: Routine Medications
- Video: Pulse Oximetry for cCHD Screening
- Video: Hearing Screen
- State-by-State Guide to Newborn Hearing Screening Regulations
- Newborn Metabolic Screening Tests
- Billing Beyond the Global: Newborn Care Services
- Newborn Care Q&A
- Video from our September 2018 Live Advanced Session
- Logic Path Cheat Sheet (printable PDF)
- In Case Of Transport: Billing for Routine Visits
- Video: In Labor Transport from Home or Birth Center (same video as in Billing Beyond The Global - Labor)
- In-Labor Transport from a Homebirth (from Billing Beyond the Global - Labor eBook)
- In Case Of Transport: Billing Based on Time Q&A
- Examples: In-Labor Transport From A Homebirth
- In-Labor Transport from a Birth Center (from Billing Beyond the Global - Labor eBook)
- Intro and General Guidelines
- Guide to Modifiers 26 and TC from the AAPC
- PAPs/Annual Gyn Exam
- ICI & IUI Insemination
- Birth Control
- Words of Wisdom for Billing Gyn
- Sample Gyn Superbill
- Video: All About the CMS-1500
- Video: How To Complete A CMS 1500
- Red CMS-1500 Form (HCFA)
- Video: What About Box 27? Should I "Accept Assignment?"
- CMS-1500 Q&A
- Facility Fee Basics
- Facility Fee Research - The Journey Begins
- A Surprising Discovery with State Regulations
- State-by-State Birth Center Regulations and Resources
- Birth Center Stay Client Survey Results
- Can I charge a facility fee for a homebirth?
- Video: What Is and Where Can I Obtain a CMS-1450/UB-04?
- Printable PDF: CMS-1450 w/Required Fields Marked
- CMS-1450 (UB-04) Walkthrough - Inpatient
- CMS-1450 (UB-04) Walkthrough - Outpatient
- Video: Choosing Your Type of Bill (Field 4 on the UB-04)
- Open Model Birth Center Q&A
- Library of CMS-1450/UB-04 Instructions and Downloadable Forms
- Bonus Section: Interview w/Desiree LeFave, Co-Owner of Bella Vie Gentle Birth Center
- List of EDI Companies
- Recording of Live Zoom with Sizzly Auer on EDI ~ April 2018
- Availity Walkthrough
- Q&A: Superbill ~ What It Is and When To Use It
- PDF Form: Superbill for Homebirth
- PDF Form: Superbill for Birth Center
- Questions To Ask Professional Billers
- Transport Billing Denied Due To Place Of Service Code
- Success story: "Sure, I'd be happy bill unbundled."
- Handout For Clients Regarding Insurance Checks (Be sure to edit to be applicable for your practice!)
- MEAC Evaluation Questions
- MEAC Post-test and CE Certificate
- Insurance Companies
- California: Medi-Cal Basics for Licensed Midwives
- California Medicaid (Medi-Cal): Useful Documents and Other Links
- Washington Medicaid
- Washington Medicaid: Washington State Health Care Authority's Agreement to Pay for Healthcare Services (Printable Form)
- Washington Medicaid: Useful Links
- Washington: ProviderOne Walkthrough of Coverage Verification and Claims Submission
“I loved this course. I'm not a numbers or paperwork person, and this course broke billing down into easy steps and made it mostly non-intimidating and comprehensible. Nicely done.”
“I loved this course. I'm not a numbers or paperwork person, and this course broke billing down into easy steps and made it mostly non-intimidating and comprehensible. Nicely done.”→Read Less
“This was a concise look into basic billing for Homebirth Midwives and very well presented. Great graphics and charts.”
“This was a concise look into basic billing for Homebirth Midwives and very well presented. Great graphics and charts.”→Read Less
“Easy to understand and navigate through the course of helpful information, I learned some new methods and information to help with billing. Thanks!!”
“Easy to understand and navigate through the course of helpful information, I learned some new methods and information to help with billing. Thanks!!”→Read Less
“Very informative!”→Read Less
“I think I knew most of what I learned and thought I might learn a bit more detail to feel more confident in billing for clients. I would have loved a more elementary breakdown of how to go about submitting W9s to insurances, tips about common kic...”→Read More
“I think I knew most of what I learned and thought I might learn a bit more detail to feel more confident in billing for clients. I would have loved a more elementary breakdown of how to go about submitting W9s to insurances, tips about common kickbacks or denials, ways to maximize the time and effort put into billing to make it make sense to add this to my workload. I still feel relatively unprepared. But maybe that's how everyone feels? ”→Read Less
“I highly recommend this course. It gives a strong foundation to understanding the basics for billing for midwives. The best part is the support and further information found in the discussion section. Definitely worth the amount paid for the co...”→Read More
“I highly recommend this course. It gives a strong foundation to understanding the basics for billing for midwives. The best part is the support and further information found in the discussion section. Definitely worth the amount paid for the course. Thank you Jesica!”→Read Less
“I thought that this would be really hard to understand but Jesica presents it in such a great and practical way! Thank you!”
“I thought that this would be really hard to understand but Jesica presents it in such a great and practical way! Thank you!”→Read Less
“After completing this course, I feel like I can actually start doing my own billing. I'm sure I will have questions, but Jesica, or the group discussion, has been really great at answering those questions quickly and accurately. This course offere...”→Read More
“After completing this course, I feel like I can actually start doing my own billing. I'm sure I will have questions, but Jesica, or the group discussion, has been really great at answering those questions quickly and accurately. This course offered a wealth of information and ongoing resources, and I am so glad I signed up for it!”→Read Less
“It was great, made a book out of it and it will be so valuable, thanks”
“It was great, made a book out of it and it will be so valuable, thanks”→Read Less
“Jesica did an excellent job in gathering all the information and putting it together in a form that kept me interested the whole time. I have a great understanding on insurance now and have sources to go to when I forget or need more help. Tha...”→Read More
“Jesica did an excellent job in gathering all the information and putting it together in a form that kept me interested the whole time. I have a great understanding on insurance now and have sources to go to when I forget or need more help. Thank you Jesica!!!!!! Sincerely, Betty Ludlow I give it a five star rating!”→Read Less
“Thanks for putting this together, it makes stepping out and billing, myself, less daunting! Keep the good stuff coming.”
“Thanks for putting this together, it makes stepping out and billing, myself, less daunting! Keep the good stuff coming.”→Read Less