01

Services
Questions

1. What does The Birth Center offer?

We offer women an unmedicated out of hospital childbirth option for low risk pregnancies. We are a full scope pregnancy care facility that supports women and their families in a Homebirth environment or Birth Center birth without the temptations of Narcotic pain relief, the stress of a ticking clock, or the changing shifts of your midwife and nurse.

Let us provide the birth both you and your baby deserve.

Pregnancy Care Includes: Prenatal Visits-11 an average, Labor/Delivery support by a midwife and a nurse, 1 & 3 day Postpartum Home visits, Seven day, One & Two month Postpartum visits in the office, & Well Woman/Annual Exam. The Postpartum Care also includes tracking baby’s weight and wellness for the first two months of life as well as lactation support when and if it is needed.

 

2. Can I have a Home Birth?

YES, we do offer home birth! But wait it gets better…we can 99% guarantee which midwife will be in attendance at your birth and she is accompanied by a registered nurse as well. Therefore, no need to leave your environment in labor…we come to you. Lastly, we will be back 24 & 72 hrs. later for your postpartum home visits.

3. Does The Birth Center offer Vaginal Births After Cesarean Section (VBAC)?

Yes, we do offer  women with a history of one C-section an option to try a vaginal birth.

However, there is an examination of the mother to confirm her eligibility to birth at the Bozeman Birth Center or for her desired Homebirth. We also require confirmation of your surgical procedure and recovery history, so bring your records with you to your Consultation or Initial visit.

4. What happens after the baby is born?

The lights are kept low and once mother and baby are stable, they are given a couple of hours to nurse and get to know each other as two. The baby never leaves you or your partner.

The immediate postpartum time is a lot of observing and evaluating, but all of this can be done while the baby is with you. Weight and measurements will be taken.

All care is done around the baby’s needs and the family’s personal preference. We honor these precious first few hours.

5. Do you vaccinate at the Birth Center?

We do not vaccinate here at The Birth Center. However, we do offer support, education, and referrals for vaccinations.

6. What happens in case of transport?

You and your midwife can only play the birth hand that you/she is dealt. As a result, if while in labor your midwife becomes concerned for your safety and/or the safety of your baby, you will be transported to the hospital.

Usually, this situation is discussed with the mother and her birth support, the hospital is called to inform them that we are bringing someone in, and your complete medical records are given to the receiving hospital.

If you have a personal physician, he (she) can be requested or the Physician on call will be there to help in your care.

Sometimes, the client is observed and monitored by the hospital AND if all is well the client is allowed to returned to their Homebirth or Birth center birth.

However, keep in mind that your midwife wants to fulfill your expectations and if your labor is progressing, your baby is descending, your blood pressure is good, and baby’s heart beat is strong, you will be given the time you need to deliver your baby under the roof you intended.

02

Education
Questions

1. Do I need to take Childbirth Education Classes?

If this is your first baby, YES! If you have other children, a refresher CBE class is available. Relaxation techniques and Labor education is only a couple of topics covered in CBE classes. The classes also offer your partner advice on how to be a supportive postpartum care provider and when to ask for help. Whether you take the class here at somewhere else, it is worth your time and effort.

2. Does the Bozeman Birth Center offer Childbirth Education Classes?

Yes, we offer them January, March, May, July, September, & November 2017. They include a variety of topics with a dose of reality. The space is limited so register early. Also, there are private class options that fit into your schedule- simply ask.

3. Do you offer “Refresher” Childbirth classes?

For a woman who has birthed a child already, these classes are for you! They are designed to reinforce what you already know by reminding how to breathe, relax, and surrender to your mind and body in labor & delivery.

03

Health
Questions

1. Is it okay for a pregnant woman to hot tub?

Using a hot tub during pregnancy is great, just pay attention to the temperature of the water. Ideally, the temperature of the water should be at body temperature or a little above. If you start to feel woozy or light headed then get out. Be sure to drink fluids before entering the hot water.

2. Is it okay for a pregnant woman to sleep on her back?

Sleeping on your back is fine in pregnancy as long as it is comfortable. This comfortability level will be different for different woman. Simply, listen to your body.

3. Can the Birth Center advise me about my diet while I’m pregnant?

Absolutely. We take an active role in helping mom and baby get the kind of well balanced diet necessary. Everyone has a different lifestyle and we can help you develop a plan that fits your tastes and helps your baby at the same time. All of this is included as part of our prenatal care.

04

Financial
Questions

1. How much does it cost to have a baby at the Bozeman Birth Center?

We pride ourselves on offering a reasonably priced option for pregnancy, birth, and postpartum/lactation support. We offer many forms of payment and payment plans. Lisa, our practice manager would be more than willing to answer your questions regarding our discounted cash pay option with those that have a high deductible, no insurance, or simply want to save some money. If you choose the cash pay option and have insurance, you can bill your own claims with the paid invoice you will receive once payment has been received in full.

2. Does the Bozeman Birth Center take insurance/medicaid?

Yes, we do accept private insurance but not Medicaid- unfortunately.

We offer mid-level providers aka Certified Nurse Midwives which are usually compensated providers. However, we are an out of network provider for all insurance companies.

Regardless of the circumstances, some insurance companies compensate better than others. So, please contact Larsen Billing to have them verify your insurance benefits for you. Their information is available by simply asking. Furthermore,  Lisa is available to help you through this confusing process: See below for clarification regarding insurance compensation.

Understanding your Insurance Claims:  Frequently Used Terms

Over Usual & Customary of Allowed Amount: 

This is the portion of the fees for service your insurance company has determined is more than they are willing to pay for the billed service.  The billed amount is usually “reduced for usual & customary” or, in other words, a reduced amount is “allowed” by the insurance company.  There is no way of knowing what this allowed amount will be until your claim has been processed by the insurance company.  If a portion of the fee is considered “over usual and customary”, this does not mean your midwife has charged too much.  This is an amount that the insurance company has determined is fair compensation for the service rendered and they base their reimbursement on this amount.  Each insurance company has their own allowed amounts for each procedure code that we bill.  You may be responsible to pay for all, or a portion of, fees for services that may be considered, “over usual and customary”.  In other words, you may be responsbile for the entire billed amount, not just the amount that the insurance company allows.

EOB:

Explanation of benefits.  This is what the insurance company sends you to explain how a claim processed.  Your midwife should also receive a copy; however, if a payment is sent directly to you, your midwife does not receive a copy.  It is very important that you give, mail or fax a copy of the EOB directly to her office if payment is sent to you.

Co-insurance:

This is the portion for which you are responsible.  If your insurance company pays at 70% of allowed charges (as explained above), 30% would be your responsibility.

Deductible:

This is the amount that you must pay out of pocket for your healthcare before the insurance company will start reimbursing for services.  Deductibles reset at either the end of the calendar year, or the end of your plan year.

Out of Pocket Maximum:

This is the amount which you pay out of your own pocket for fees for services rendered.  This includes your deductible and co-insurance payments.  The patient is legally responsible for all deductible and co-insurance amounts.

Types of Insurance Companies:

  1. HMO, Managed Health Care, and Medicaid.  This type only covers in network or participating providers.  A participating provider is someone who has a contract with an insurance company for his/her services.
  2. PPO/POS or Indemnity Plans.  PPO or POS plans allow you to choose your provider by going “out of network” and possibly paying a bit more for the services out of pocket.  An indemnity plan is a traditional old-fashioned insurance plan, pre-HMO days.  You pay your deductible and co-insurance and you can choose your provider without the restrictions of an HMO provider list.

Scenario for PPO/POS or Indemnity Plans

Many people who have insurance are surprised when they have a balance due to their midwife even after claims have been paid by their insurance company.  It is difficult to determine how much an insurance company will actually pay for services rendered (even after obtaining verification of benefits), and many times there will be an outstanding balance due in spite of the upfront deposit payment and payments from the insurance company.  Below are examples of possible scenarios to help explain why this might happen.  These are EXAMPLES only and do not necessarily reflect what your midwife charges, nor what your benefit level is.

  1. Let’s say your benefit level is 70%, your deductible is $500.00, and the fee for service is $4000.00.  Assuming that the insurance company accepts the full $4000.00 fee, the benefit paid would be $4000.00 MINUS your $500.00 deductible = $3500.00, MULTIPLIED by .70 (70% benefit level), resulting in a $2450.00 payment by the insurance company.  This leaves you, the client, with a $1550.00 ($500.00 deductible and $1050 co-insurance) remaining balance to pay your midwife.
  2. If the insurance company did not accept the full bill of $4000.00 and decided that $400.00 was over usual and customary, then the benefit paid would be $4000.00 MINUS the $400.00 over usual and customary and MINUS your $500.00 deductible = $3100.00, MULTIPLIED by .70 (70%).  This would result in a $2170.00 payment by the insurance company and leaves you, the client, with an $1830.00 ($500.00 deductible, $400.00 usual and customary and $930.00 co-insurance) remaining balance to pay your midwife.

Please remember that if an insurance company chooses not to accept your midwife’s full fee, it does not mean she charges too much.  By agreeing to work with her, you understand that you may still have a balance due after your baby is born and that you may or may not be reimbursed your full prepaid deposit.  Accepting these terms and employing your midwife’s services, or those of the birth center, are a binding financial agreement.

Depending on insurance reimbursement, you may receive reimbursement from your midwife if you have paid all, or a portion of, your deposit that you paid upfront for non-cash pay option.  There is no way of knowing where you will receive a refund until your claims have processed.

 

3. Does the Birth Center issue a Birth Certificate?

Yes, within the first week of the baby’s arrival their birth certificate will be filled out. Usually at the 7 day visit in the office the mother of the baby will be asked to edit the certificate, sign it, and okay it to be filed with the state of Montana. Do not worry if you do not have a final name picked out at delivery, there is time to meet your baby and decide after you leave the facility. You will be given a non-legal copy of the certificate after signing and filing to show proof of birth and documentation filed with the state. You may also file for the social security number at the same time.

4. How much does an official Birth Certificate cost?

The non-refundable fee for the first copy of a certificate is $20; each additional copy ordered at the same time is $15. Fees for additional copies will be refunded if no record can be found. Payment should be made to DHS/Vital Records.