About two months ago I posted about this issue here . Basically what happened is that I changed insurances around July/August 2022 because my husband got a new job (first insurance I purchased on my own through market place). The baby’s birth was on September and the new insurance only paid for part of the delivery claim saying it was a prorated service. On my first post people said it can be a thing when the doctor that assisted the birth is associated with the clinic where I went to for the prenatal, the clinic charges for the pregnancy as a whole at the birth. The doctor is associated with the clinic (I didn’t do my prenatal with him directly though), but the first insurance already paid for the prenatal visits, ultrasounds and other tests (I didn’t have to pay anything for the visits because they were free accordingly to the explanation of benefits from the first insurance, but I did pay my share of the ultrasounds and tests already).

On the delivery claim it shows to me as “OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM” which makes me think that they are charging only for the procedures done on the delivery day and not the whole pregnancy care. I am going to call the clinic again to confirm that that is the case, and then call my current insurance again.

I just wanted to know if anyone here had gone through something like this and any ideas of how to get my current insurance to pay for the whole claim (I understand I will still have to pay copays, etc) if the claim is only for the procedures done on the delivery day.

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