Expecting parents should be aware of this office's billing policies before scheduling a first prenatal visit.
We contacted this office to establish prenatal care. At the time of the scheduled appointment, my wife was 12 weeks pregnant and had already had a prior ultrasound confirming pregnancy.
Despite this being, by definition, an initial prenatal visit with a new provider, we were informed the appointment would be billed as a new patient office visit rather than prenatal care, even though our insurance covers prenatal care at 100%.
During conversations with billing management, we were told the visit would not be billed as prenatal care because pregnancy had not previously been established with their office. This was stated repeatedly using language such as, "we don't know that you're pregnant," despite confirmation via prior ultrasound. The tone of these conversations came across as dismissive and condescending rather than collaborative.
We were informed this was their policy and that it would not be changed or adjusted, even with confirmed pregnancy documentation. Our understanding is that once pregnancy is medically confirmed, visits for obstetric care are typically billed as prenatal care, regardless of whether the provider is new.
These discussions occurred prior to any in-office care. Based on these conversations, it was clear that billing decisions were strictly policy driven, with no flexibility to work with patients or insurance on appropriate coding or resubmission. We ultimately canceled the appointment and sought care elsewhere.
Sharing this experience so other expecting parents are aware of the office's billing approach and communication style before scheduling. read more
