Insured Clients

Paying for Care - Financial Planning During Pregnancy

Financial planning is an essential component of preparing for the birth of your baby. The Minnesota Birth Center (MBC) is happy to be your partner in navigating your insurance and planning for your pregnancy-related healthcare costs so that upon the arrival of your sweet baby there are no financial surprises.

Financial Policy for insured clients:

– Self-Pay Clients, please click here

MBC’s financial policy is that you prepay your insurance deductible by 37 weeks of pregnancy as a down payment toward your anticipated costs for care. If you are planning on birthing at one of our birth centers, MBC will also collect a down payment as an estimate for your baby’s care, depending on the details of your policy. If your care spans two years (for example you are receiving care in 2019 but due in 2020) we will collect your full deductible amount based on your due date.

We hold these prepayments in your MBC account as a credit. As claims for your care process with patient responsibility, we will draw from your prepayment to satisfy the amount due. At the conclusion of your care with MBC any amount you have overpaid will be refunded to you, and any amount you still owe (perhaps due to co-insurance, co-pays, or an uncovered service) will be billed to you.

Our hope is that by prepaying a good chunk of the cost of your care before your baby even arrives that you will have fewer bills to worry about postpartum.

what you can expect when you establish care at MBC

Prior to your first visit with us, you will be presented with a financial contract that reflects your prepayment amount (deductible only). We ask that you make a plan to prepay this amount by completing your contract no later than your second visit. You get to choose when and how you prepay (e.g. one lump sum or multiple prepayments), as long as prepayments are made by 37 weeks or alternative arrangements have been made.

Please take a moment to review the most commonly asked questions about paying for care at MBC. In addition, our Billing Team is happy to assist you via phone or email (612-545-5311 ext. 1 / billing@theminnesotabirthcenter.com). We respond to billing inquiries within two business days.

Frequently asked questions

I have commercial insurance. Is MBC in-network on my plan? Will my insurance cover care at your birth center?
MBC is contracted with every major insurance company in the state of Minnesota, including:

  • Aetna
  • Blue Cross and Blue Shield
  • Cigna
  • Health Partners
  • Medica
  • Preferred One
  • UCare
  • UMR
  • United Health Care. In addition, MBC is a participating provider with United for the VA Community Care Network program for due dates 10/7/2019 and onward. 

However, every insurance company has many different plans, each of which cover services differently.Therefore, it is important that you call your insurance company to verify that MBC is in-network for your plan. Sometimes it is helpful to provide our Tax ID, which is 27-1689468.

In most instances MBC is in-network, but it is still important for you to do this double-check. While you are at it, also confirm that Quest Diagnostics (our primary lab processing facility), and Abbott Northwestern and United Hospitals (our transferring hospitals) are in-network as well. If you learn that MBC, the hospitals, or Quest is out-of-network, please contact our Billing Team to discuss potential next steps.

MBC is not able to accept out-of-state Medical Assistance plans, Tricare, or Veterans Benefits.

Do you take Medical Assistance?
MBC is happy to accept MA plans from the state of Minnesota. At this time, we are not contracted with Hennepin Health and therefore cannot accept this form of Medical Assistance. We also cannot accept out-of-state MA.

Note that when you apply for MA you are usually put on “straight MA” through the state of Minnesota and later transferred to a commercial MA policy such as BCBS-MA, Health Partners-MA, or UCare-MA. Please notify MBC when this change takes place so that we do not submit claims for your care to the wrong location.

How much does having a baby with MBC cost? What can I expect my responsibility will be?
While we’d love to give you an exact dollar amount (right down to the penny!) the amount that you will ultimately pay for your birth is dependent on the specific details of your insurance policy and the care you receive over the course of your pregnancy and birth.

If you have insurance, the best way to determine coverage is to call your insurance company and review with them each CPT Code listed in the MBC BirthBundle® (see below). Based on this information, your insurance can tell you which services are covered and which would count toward your deductible. Once you meet your deductible, you may have co-insurance, which means that you are responsible for a portion of costs up to an out-of-pocket maximum. This information should help you to calculate an estimate of your costs for care with MBC. In the event that additional care is necessary MBC will submit claims for your care accordingly.

Remember that any estimate that you calculate from the BirthBundle® is for routine care at MBC. It does not include the cost of labs (typically sent to Quest Diagnostics), problem visits, non-routine care, or any care received at Abbott or United Hospitals or any facility outside of MBC. These businesses will bill you directly. Remember to confirm that each of these entities is in-network on your insurance policy.

MBC’s providers (Certified Nurse-Midwives, RNs, Sonographers, and Medical Director) are committed to practicing evidence-based care and will only assess, test, and treat when medically indicated.

BirthBundle®

CPT / CARE FOR MOTHER / PRICE
99205 / 60 min Initial Consultation / $400.63
81025 / Pregnancy Test / $15.00
99000 / Specimen Handling x 3 / $27.60
36415 / Venipuncture x 3 / $36.00
59400 / Maternity Care / $4,590.00
96127 / Mental Health Assessments x 6 / $90.00
76805 / 20wk Ultrasound / $418.13
59409SG / Facility Fee / $4,900.00
A4550 / Delivery Supply Kit / $150.00
99349 / Home Visit / $225.00
Mother Total / $10,852.36

CPT / CARE FOR NEWBORN / PRICE
99464 / Newborn Exam / $315.00
99463 / Care and Discharge / $285.77
J3430 / Vitamin K Injection / $30.00
99463SG / Newborn Facility Fee / $1,500.00
99348 / 24 Hr. Home visit / $156.00
99000 / Specimen Handling / $9.20
36416 / Heel Stick / $5.00
92558 / NB Hearing Screen / $150.00
S3620 / Metabolic Screen / $187.44
Newborn Total / $2,638.41

TOTAL BILLED TO INSURANCE$13,490.77
AMOUNT YOU OWE: DEPENDENT ON THE SPECIFIC DETAILS OF YOUR POLICY
Please note that the costs above are subject to change.

How does MBC compare to the cost of a hospital birth?
Most people don’t realize that birth centers are usually a more cost-effective option than hospitals. As an example, here’s a snapshot of the Facility Fee billed for Mother’s stay at a few local hospitals compared to a stay at MBC. The hospital fees are based on an average two day hospital stay and the averages for calendar year 2017.

Service FacilityVaginal Delivery w/o complications*Normal Newborn*
Abbott Northwestern$14,041$5,390
HCMC$13,238$3,848
United$15,798$5,423
University of MN$13,527$4,425
Woodwinds$11,257$4,822
MN State Hospital Avg$13,572$4,782
MBC$4,900$1,500
Average Savings$8,672$3,282

If you have co-insurance on your insurance policy (i.e. the percentage of healthcare costs that you pay after your deductible has been met), then the cost-savings can be significant.

*Note: These charges reflect the average of what the hospital charges for use of their facility. This price does not include charges for the provider or other professional fees, such as pharmacy, diagnostic imaging, or lab work.Source

Does my baby need insurance?
Yes! If you birth at the Minnesota Birth Center your baby will receive care from our team, and we will have claims to submit to the baby’s insurance. It is best to do some research in pregnancy to determine how you will insure your baby, as well as what paperwork the insurance company requires in order to add your baby to the policy. We ask that you give us the details of your baby’s coverage no later than 30 days after the birth so that we can submit his/her claims for care and so that this cost does not fully fall to you.

What if I have two insurance policies?
Let us know as soon as possible. You will need to communicate with both insurance companies that you have dual coverage and work with them to determine which policy is primary and which is secondary. Claims for care must first be submitted to the primary company (4-8 weeks’ processing time), and then submitted to the secondary company (another 4-8 weeks’ processing time). Given this more lengthy timeline, it is imperative that companies know that you have dual coverage and that both know whether they are first or second in line to pay claims.

There are specific rules about which policy will be first and it’s important to know that you do not get to pick which one is primary. Please carefully consider dual coverage to ensure it makes sense for you and your family once you have all the facts about the costs and benefits.

One final note on dual coverage: We prepare your financial contract and prepayment plan based on the lower of the two deductibles.

What happens if I'm planning on switching insurance during my pregnancy?
Don’t worry – insurance changes are common, especially when you have a big life event like the birth of a baby. Just let us know as soon as you have switched. We’ll need to know:

  • The new company name
  • The new ID and Group numbers
  • The effective date of the change. This is extremely important to ensure claims are submitted to the correct company.

Once we have updated information from you we will update your financial contract to reflect your new deductible and prepayment amount.

I have a health savings (HSA/HRA/FSA) account. Can I use it for care at MBC?
Definitely. Sometimes these accounts have debit cards that allow for prepayments and if so, you can include that information directly on your financial contract. In other instances certain accounts such as FSAs do not allow for prepayments. If this is your situation, contact our Billing Team to work out an alternate arrangement.

I prepaid money to MBC, but it’s not showing up on my insurance website? Why not?
Great question. Remember that the money prepaid to MBC is held in your MBC account as a credit (sort of like putting money in a “piggy bank for birth”). MBC makes withdrawals from that “bank” as we process your claims for care. It’s only when a claim is processed that you’ll see it reflected on your insurance website. If you are set up with a pre-payment plan at MBC, you shouldn’t receive statements (bills) from us, but you may receive Explanation of Benefits statements (EOBs) from your insurance company, explaining how claims are being processed and how much you owe thus far. EOBs are not bills, so do not pay them! At the end of care, we’ll submit a final claim for your birth – any excess you’ve prepaid to us will be refunded to you. For any amount still owed we will send you a bill.
What happens if I transfer out of your practice prenatally?
If you want or need to transfer out of MBC care, our Billing Team will be notified. We will submit claims for the care you’ve received thus far. Once these claims process we will use any amount you’ve prepaid to cover the cost of that care. Any excess you’ve prepaid to us will be refunded to you. For any amount still owed we will send you a bill.

What happens if I need or want to transfer to the hospital in labor?
In instances of transfer to the hospital, your billing would reflect the care you received at the Minnesota Birth Center as well as any care our midwives provide at the hospital. If you transfer to the hospital in labor, you will not be charged by MBC for any baby care, because the hospital and their providers will charge for these services. Note that a Facility Fee would be charged by both MBC and the transferring hospital, but MBC’s Facility Fee would be less than the rate listed on our website. As with a birth center birth, we will wait for your claims to process and use any prepayment amounts to go toward those costs. Any excess you’ve prepaid to us will be refunded to you. For any amount still owed we will send you a bill.

I am considering genetic testing in my pregnancy. From a billing standpoint, what do I need to know?
MBC commonly uses Progenity for genetic testing. It is important to confirm that your insurance covers this test, as the out-of-pocket cost can be very high. Your insurance may not cover the test at all, or may cover it only if you have a family history risk factor or are above a certain age. Please note that Progenity will often accept a “prompt-pay” discount if the test is not covered by your insurance. In most instances, the cost to you is negotiated down to about $100. Contact the number on your Progenity bill for details.

What if I have a question not answered here?
Not to worry – the MBC Billing Team is happy to help. Email us,
or call 612-545-5311 ext 1. We’ll respond to your inquiry within two business days.