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Frequently Asked Questions

  • Do you participate with insurance companies?
    After careful thought and consideration this is a self-pay practice. In order to give full holistic care to expecting mothers and women the Midwife Model of Care™ is practiced. The common insurance company does not recognize the value of this and minimizes pregnant women to diagnosis codes. They tend to focus on quantity of care and not the overall quality of care. Once your bill is paid in full we intend to give you a detailed bill of service with all the necessary codes to file directly with your insurance and get the reimbursement they offer. We do ask for your insurance information to have available for any tests we may collect. The Laboratories and Radiology services we use as part of your care will file your insurance for their services.
  • What are your fees?
    The fee for our services is as follows: Full Maternity Package for Homebirth is $5500.00 Full Maternity Package with birth at "The Cottage" is $6000.00. The additional fee is for rental of "The Cottage" in collaboration with Grace Midwifery. Mini Maternity Package for CNM led Prenatal and postpartum care is $3000.00 Gynecology care depends on the type of visit. A Well Woman Exam is $150.00 A Problem Gynecology visit is $100-$150.00 In office testing charges are kept to a minimum A detailed list can be provided to you at your request.
  • Are there any other out of pocket expenses?
    Any laboratory and imaging visits are billed to your insurance by the place giving the services. Other costs will include payment to the Birth Assistant, purchasing a birth kit, birth tub rental (if desired), newborn metabolic screening collection card, childbirth education, supplements, Doula services (if desired), and any medications that may be necessary during your delivery.
  • Do you have any resources to help me pay for this service?
    We will be honest and open with you from the beginning regarding the fees and will help set up a payment plan that best suits you. There are certainly Medical Loan services available to help with expenses up front. Credit cards are also accepted for payment. All pregnancy care (including newborn and postpartum care) will need to be paid in full by 36 weeks of pregnancy.
  • What forms of payment do you take?
    Cash, check, credit card, & Venmo
  • Do you have a billing service?
    We do not have a billing service since we are a self pay service provider. However, we have an account for our clients with SLB billing. SLB billing is a Midwife owned and run billing and coding company specializing in getting reimbursement for Midwifery care. You will basically hire them and they work directly with your insurance company to get the best reimbursement possible. Some clients self-file with their insurance company and do the work of discussing reimbursement. Any paperwork you need to assist with this will be provided by us and our administrative assistant.
  • What is included in the cost of care?
    Your prenatal package includes all of your visits throughout your pregnancy. Home visits by the CNMs can occur if you live in the Winchester area. If you are having a baby at home or at "The Cottage" your package includes intimate and personalized care during your labor and birth, immediate care of your baby, and visits to you and your baby 4 times after you have given birth. If you plan to see us only for Prenatal care the package includes a 2 and 6 week postpartum visit. All prenatal packages also include the ability to communicate directly with us as needed for questions and advice. This is discussed at the first visit in detail.
  • Am I a good candidate for an Out of Hospital Birth with midwives?
    Our practice is designed to take care of Low Risk pregnant women. A risk assessment will be completed at our initial meeting to see if you can safely consider out of hospital birth. Should your pregnancy become complicated we can sometimes co-manage your care with other providers. While we are extremely supportive of women who have had a previous Cesarean Section we do not perform VBAC (Vaginal Birth After C/S) outside of the hospital setting. We encourage our clients to have prenatal care with us and report to the hospital for their VBAC. We can offer doula services by the CNMs if you desire.
  • What happens at a midwife visit?
    We get to know each other and gather the necessary health information needed to show us signs that a baby and mother are progressing safely together. Plenty of time is spent giving guidance regarding nutrition, self care, and stress reduction. We discuss lab results, ultrasound results, and how birth happens. We encourage gathering as much knowledge as possible before labor and birth so a new family is prepared.
  • How do I get a birth certificate and Social Security card?
    We will file your birth certificate for you and give you instructions on how to get a copy of the birth certificate and how you get a social security number for your baby.
  • What is the difference between a OB/GYN and a Nurse Midwife?
    A Nurse Midwife is a healthcare provider trained in the disciplines of Nursing and Midwifery. We specialize in low risk and normal pregnancy and birth. An OB/GYN is a medical provider who is trained in the art of Obstetrics and Gynecology. Obstetrics encompasses low risk and high risk pregnancy conditions and includes surgical intervention as necessary. Gynecology is the medical and surgical care of a woman's reproductive system for a lifetime. Both disciplines must meet minimal requirements and sit for a Board Exam. They both must maintain their certification and continue to meet safety requirements as set forth by their certifying organization.
  • What happens if I need to transfer out of care during my pregnancy?
    We keep detailed records of our visits and any laboratory and ultrasound testing completed. We then can share these with the medical providers that are a vital part of the health care system to handle high risk and complicated pregnancies. We have worked with many amazing physicians throughout the years and know they strive for a safe outcome for you and your baby as well.
  • Do you have a medical doctor you are able to consult with if necessary?
    We are an independent Nurse Midwifery group but have open dialogue with many OB/GYNs and Maternal Fetal Medicine experts. If you need to be transferred to their care we will make it professional and ensure you are getting excellent medical care. We also have dialogue with other Midwives in our community and at the National level to be sure standards of care and evidence based practice are followed.
  • What if something happens during labor and I need to transfer out of care?
    We will stay with you as your Midwife until care is assumed by the Medical provider receiving you. Most of our clients will live within the Winchester Community and transfer will likely be to Winchester Medical Center. OB Hospitalists and CNM Hospitalists are available 24-7 should you need to transfer.
  • Do I have to take my baby to a Pediatrician after birth?
    We prefer your baby to have a checkup at a health care provider within a week of delivery. We will send a copy of the baby’s birth record with you. We truly suggest meeting with a provider during your pregnancy to see if they seem supportive of your philosophy in healthcare and raising your children.
  • What newborn testing do you offer?
    State required Metabolic screening and Congenital Cardiac Heart Defect screening will be completed by me at your postpartum exams.
  • Do you offer breast feeding support?
    As a former breastfeeding consultant and past breastfeeding mother Karen is passionate about breastfeeding and the amazing benefits it offers to families. Sandra has helped many new mothers along the way with breastfeeding as well. We will assist you after birth and give guidance along the way. We know several Lactation consultants who are excellent resources if breastfeeding has challenges. We encourage our patients to attend local La Leche League Meetings for guidance and support!
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