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Fees and Financial Policy
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Midwifery is a demanding commitment that requires a midwife be
on call 24 hours a day, 7 days a week. We incur many expenses and make
many sacrifices in order to provide this service.
Therefore,
ESMI must be paid.
We do accept insurance, but recently, due to
new financial policies among many insurance companies, most of these
companies have been extremely slow in their reimbursement and others
very poor in honoring their commitment to reimburse. Because of this
situation, we require that you pay 30% of the basic fee ($1365) or your
deductible if that is greater than half our basic fee before 37 weeks.
When your insurance company pays us you will be reimbursed accordingly.
If your insurance company does not pay in full within 12 weeks of the
birth you will be required to pay the full fee of $4550 plus any other
expenses incurred during your care.
Our basic full fee is $4550.
However, to encourage prepayment, we will discount our basic fee by
about 40% to $2800.00 if paid in full (less $300.00 paid at the birth)
by 37 weeks of your pregnancy. The $2800.00 (less initial deposit – see
deposit guide below) is paid in equal monthly installments up to the
37th week. You will still be responsible for non-standard lab work,
RhoGam, sonograms, physician consult referrals, dietary supplements,
etc. If payment is not received before the end of the 37th week, then
you will be required to meet the full fee payment. In very special
circumstances, we will allow late payment up to the time the birth. If
these payments are not received by the day of the birth, you will loose
the prepaid discount and the amount owing will revert to the full fee of
$4550 plus other expenses incurred during your care with 60 days to
pay. After that late fees will be charged at 5% per month.
There
is a call out fee (some midwives refer to this as an assistance fee) of
$300.00 due at the birth. This is part of your fee but just saved to be
paid as the midwife is called out to your birth. This fee is due on
arrival. In the event that ESMI has to call another midwife for
assistance, then this fee will be paid to them. Cash is preferred for
this reason.
If you decide to give birth at one of the local
birthing centers, there will be a facility fee of $500 - $1,200. If you
carry insurance, most birthing center will bill them directly. If you
don’t carry insurance, you will be responsible for providing the
facility fee in cash at the time of the birth.
The ESMI fee
includes all routine prenatal care, standard lab work, one home prenatal
appointment at or around 36 wks, normal intrapartum care, labor
transport if necessary, one home post natal appointment, and 12 weeks
care for you and your baby, with a pap smear offered at the 6 wk.
appointment. It is ESMI’s practice and intent (barring unforeseen
circumstances) that there will be at least 2 qualified attendants, 1 of
whom is a midwife, present at your birth to ensure comfort and safety of
both mother and baby.
Formal medical consultation and
referral can usually be arranged, but you will make your financial
arrangements with that provider. We will do our utmost to refer you to a
physician that is agreeable to your proposed home/birthing center birth
plan, but ultimately, you are responsible for obtaining services of any
additional medical caregiver.
We require an initial deposit
when you contract ESMI as your maternity care providers and before we
can begin your care. The amount of this deposit will vary according to
when you take on midwifery care. If your care begins:
In your
1st trimester (up to 12 weeks) $400
In your 2nd trimester (up to
27 weeks) $550
In your 3rd trimester (28 weeks or beyond) $750
This
deposit is not refundable.
The remainder of your bill will
be paid in installments with the balance paid by 36 weeks of pregnancy.
There will be a fee of $25.00 for any returned checks. If more than 2
checks are returned then all other payments must be made in cash or by
money order or credit card.
Payment of these fees does not
guarantee an out of hospital birth.
If you transfer to
another care provider prior to 36 weeks we will refund any money paid in
advance after the deduction of: the deposit relating to the trimester
you are currently in, $235.00 for the initial booking and history, $200
for initial labs $120.00 per prenatal consultation attended, $25 for “no
show” appointments, $25 for telephone consultation outside of normal
working hours, $10 for telephone consultation during office hours, and
any further expenses incurred during you care. This will be itemized in a
statement. If transfer occurs after 36 weeks, no refund can be given.
Post partum care can still be provided regardless of method or place of
birth.
Should any disagreement or misunderstanding arise
regarding financial matters or services rendered, we all agree to
resolve the issue person to person. If mutual agreement cannot be
reached, all parties agree to attempt mediation to resolve the issue
prior to instigating any other action (including legal recourse). Since
Dispute Resolution Services (817-626-6479), is the county agency
providing public funded mediation services for Tarrant County, all
parties agree to utilize Dispute Resolution Services to provide
mediators and facilities for any mediation that may become necessary.
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