The global homebirth fee at Riverside Midwifery is $4000 for new clients plus $1000 for additional birth assistant, supplies, and home visit expenses. You can expect the Certified Nurse Midwife and a trained birth assistant to be present for your birth, with additional attendants such as a midwife student with your permission.
Global fee breakdown:
Midwifery fees for all care and routine supplies/equipment/meds that the midwives carry: $4000
Birth assistant payment: $550
Birth kit/supplies provided by Riverside Midwifery: $50
Home visit travel/gas x 7 visits: $350
Welcome kit: $25
Lab collection: $25 (for initial labs, 28 week labs, and 37 week GBS)
This fee includes:
- All prenatal visits, labor and birth, and postpartum care through 6 weeks. This includes regular office prenatal care up to 36 weeks and home prenatal care after 36 weeks.
- Extensive postpartum care includes immediate care after birth, a home visit at 24 hours, 1 week, and 2 weeks, and an office visit at 4 weeks and 6 weeks.
- Routine lab collection at the office (please be aware there is a separate fee charged by the lab for processing the labs).
- The newborn’s well-baby care from birth through 6 weeks.
- The homebirth supply kit, a one month supply of NORA tea, and various educational resources are also included
Other services provided by Riverside Midwifery include GYN/well-woman care. Individual charges may include the following:
- The rental of our professional birth tub (model Eco Pool in a Box Pro) with liner and kit is $150. You will need to supply the fill hose and sink adapter.
- Well-woman care – Initial/new client $150 including pap collection, return client $100 including pap collection
- Private consult/interview with the midwife before initiating care $100. This would be in lieu of the free monthly meet and greet.
- Tongue tie evaluation and clipping of class 1 and 2 anterior tongue ties $100
- Mileage/travel surcharge for additional home visits $50/visit
- Rhogam injection if required at 28 weeks and/or immediately postpartum $180
- Virginia Metabolic Screening Card $76 (this is the only state served that charges additionally for the test card)
- Additional supplies, tea, educational materials, supplements, etc as marked
- The global fee for service is expected to be paid in full by 36 weeks unless otherwise arranged. All clients are offered flexible payment plans.
Due to the variability in insurance reimbursement we are a self-pay practice. Forms of payment accepted are cash, check, and credit card. There is a 3% service fee for credit card payments.
As a separate service to the client, Riverside Midwifery has contracted with a professional homebirth billing service that will submit midwifery charges to the client’s insurance on the client’s behalf if the client so chooses. Please note that there is a commission fee that is assessed by this billing service based on the insurance final “allowable” amount; this fee is collected when the insurance payouts occur. You must complete a verification of benefits through the biller to get an idea of what to expect for your insurance reimbursement. The professional billing service we utilize is SLB Billing. Please go to their website for benefits verification, enrollment to bill your insurance, etc. You will be essentially hiring this group to bill on your behalf and it is important to fully review the services.
Please note that if you choose to self-bill the insurance company Riverside cannot provide a superbill with codes as of 10-01-15 due to the ICD-9 database being changed to ICD-10. These codes are public access and it will be the client’s responsibility to research them if they are choosing to self submit their expenses.
In addition, Riverside Midwifery charges a $250 administrative fee
to account for the extra time and cost involved with interacting
with insurance companies while your claim is being processed.
This applies whether you self-bill or use SLB Billing Service.
Insurance companies are not accustomed to this model of care. They pay according to the industrialized healthcare system which emphasizes efficiency and productivity, not the development of respectful, trusting, and deeply invested relationships between client and midwife with no hamper of time and cost. Simply put, the codes billed to insurance cannot and do not translate to appropriate payment for the intensive care the Riverside midwives provides. Because of this, it is necessary to understand that Riverside operates on a self-pay, fee for service system with clients. They are expected to pay the midwifery fee out of pocket on an agreed upon payment plan.
There are certain situations where discounts can be applied depending on your financial situation, ability to pay the balance early, or whether you plan to bill insurance or not. Late entry to care (after 30 weeks of pregnancy) may be eligible for a discount if complete prenatal care was received at another practice and all records are available. All services can be paid through a Health Savings Account or Flexible Spending Account. You can also explore the option of medical loans.
$300 less early pay discount if paid in full before 28 weeks
$250 less for late entry to care (after 32 weeks) provided complete prenatal records are available and fees are paid in full by 36 weeks
Barter arrangements can be made depending on Riverside’s business and employee needs. Barter arrangements will be at full value of your services and our services. In other words, we do not provide discounts and then barter at your full service value.
On an as-available basis we can discuss financial hardship discounts.
Repeat clients previous global fee charges are honored with the addition of the birth assistant’s fee adjustment, travel fees for additional home visits, and supply cost adjustment.