Midwifery Billing Workflow

You'll need basic information on the client, the member (if the policy is through a spouse/partner/parent), and a copy of their insurance card (both front and back!). Ideally this information will be collected with enough time for a VOB to be completed prior to the start of care.

Completing a Verification of Benefits is the only way you'll be able to estimate what portion of your midwifery services will be covered by their insurance. For details on how to perform a VOB, please refer to the Billing for Midwives flagship course.

If the client has requested a discount up front, evaluating for and applying this discount from the start will provide the most clarity. (Discounts can also be applied later, if needed.) Detailed information regarding discounts can be found in the Billing for Midwives' mini-course, Safe(r) Discounts.

Based on the VOB, and any applicable discounts, the client should be provided with an estimate of what their out-of-pocket cost will be, and a financial agreement that is specific to their circumstance.

Unless they have paid their client invoice in full at the start of care, you need to regularly bill your clients to ensure you collect from them as agreed upon in their financial agreement.

After the birth, after care is complete, or both, you will submit claims to the insurance company.

After insurance has paid, you will reconcile the true charges (vs estimated charges), along with what the client paid and what the insurance paid, and issue a refund or final bill to the client, as applicable.