Seeking Approval for Home Birth

My wife and I are attempting to get her health insurance (Anthem Blue Cross and Blue Shield of Georgia) to cover an upcoming home birth in Louisiana. The plan only covers Certified Nurse Midwives (CNM), but there are no CNMs who do home births in our area (a major metropolitan area).

We have decided to still go forward with the home birth using a non-CNM Midwife, but would obviously like to have our insurance cover as much as possible. The Midwife submitted a request for "999 Unit(s)" of CPT 99244 (Office/OP CONSLTJNEW/EST PT MOD MDM 40 MINUTES), which was denied by Anthem because the request tells them our doctor asked for a referral to a provider that treats female conditions (OB-GYN), that is not in network and that the plan network has providers with the same skills who are able to provide the requested service.

From my untrained reading, it seems like the midwife just asked for regular prenatal care, so they are denying that because that can be obtained from an in-network OB-GYN. However, we are concerned about getting pre-approval for the actual birthing at home. Has anyone had any luck or know what we should submit to get pre-approval for the actual home delivery care?

Thanks in advance.

submitted by /u/Barnaby_McFoo
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