Enrollment in Medi-Cal, California's Medicaid program, represents approximately one-third of the state's population.
You know that in lower income communities these numbers are more like 50-70% of the community population.
The average cost of Midwifery care for the cash pay client is $6500.
I know that when I was birthing babies, we could not pay that fee on our income.
I spent 3 years offering sliding scale and reduced rates for families with financial needs. The truth was even $2500-$3500 was a stretch for these families. Families that truly desired the OOH experience. Families that had no options. Also, we cannot make these reduced fees sustainable in our businesses.
I set out in 2018 with a small group of LMs to make this work. Most of us in that group are still doing this and getting paid. It's been a long hard road, and I want to share what I have learned. My mistakes, my WINS!
This class is for you if...
You are a Midwife in California and interested or already accepting Medi-cal clients.
You are concerned about how to make Medi-cal work for your practice
You are overwhelmed with getting started.
You are having trouble getting paid
You don't know the first thing about billing.
If you are a solo provider or part of a group practice.
If you do homebirths or if you provide birth center services.
Everything you need to know to get started as a Medi-Cal professional. The application process, business requirements, documentation, and more.
Step by step guides to filling out billing forms for professional services. Access to billing code list most commonly used in Midwifery care.
Step by Step guide on how to fill out Facility claim. Codes most commonly used. How to bill transfers.
Access to templates
Have access to templates I have created for LOAs, referrals, letters for clients and more.
Q & A after each session
Every week we will end with a 30 min Q & A session.
Every registered practice will receive a 1-hour complementary private session to discuss your practice needs, concerns, and struggles.
How do I make it work
I'm going to share with you all my "learned the hard way" lessons. How I run my clinic model. I will share how my practice is doing financially with this payment method, what I would do again and what I would change.
Help with set up
Need your billing back end set up? We have the perfect solution for you. In less than 24 hours we can set up your back up billing on client care. You will be able to create claims in less than 5 minutes. Saving time and money.
Week By Week ....what can you expect
Week 1: August 3rd
Intro to Medi-Cal terms
Medical Malpractice requirements
Resources for applying for a DBA, NPI, and Tax IDs
Do you even NEED to be a Medi-Cal provider?
Week 2: August 10th
Professional Billing -what is it
Codes we commonly use
How to bill with OB specific codes and Midwife specific modifiers
Step-by-Step walk through on how to complete a CMS 1500
Week 3: August 17th
Codes commonly used, modifiers, rates
Step By Step walk through on how to complete a claim on a UBO4.
The founder of Antelope Valley Birth Center and California Licensed Midwife.
I became a LM in 2015, opened the Birth Center in 2016. By 2018 I was seeing a need for insurance options to access Midwifery care in my community.
I took on the task of becoming a Medi-Cal provider. Ever since we have self-taught ourselves the billing and the ins and outs of accessing benefits for clients. Today over 60% of my practice is on Medi-Cal. We are contracted with 2 county plans. We now see over 50 Families a year with Medi-Cal.
Today I sit on the board of the Midwifery Advisory Counsel, and The California Chapter of The American Association of Birth Centers. I have witnessed the increase in interest and frustrations Midwives all over the state in relation to access to care. It is now my proclaimed mission to help those who have a passion for providing services within this broken system.
FREQUENTLY ASKED QUESTIONS
We've got A's for your Q's
How much does it cost?
This full 5-week course with lifetime access is $350 dollars. You will also receive 1 hour one on one Zoom session with Tesa to discuss strategies and struggles. You will receive lifetime access to the Masterclass. Bonus: free membership for 1 year to Midwife 2 Midwife community forums.
How do I know it's for me?
If you have thought about becoming a Medi-Cal provider but are overwhelmed with all the steps to accomplish the application, this is for you. If you want to know how to bill for Medi-Cal services, this is for you. If you want to contract with a local MCP, this is for you. If you are not sure if you can take on the burden of becoming a Medi-Cal provider, this is definitely for you. At the end of this course, you will know if you can handle financially, physically and emotionally walking through this journey.
Does it matter if I'm not a Medi-Cal provider?
Nope! In the very first week I will spend time outlining all the requirements, how to access the applications to get you credentialed. By the end of week one you will know exactly what you need to get through the application process.
What if I have a birth?
We are all Midwives here. All the classes will be recorded and made available with in 24 hours. You will be able to view the course and the Q&A sessions. If the Instructor needs to reschedule due to a birth, an alternate class date will be provided.
When can I get started?
Each week the course will open Wednesday mornings so you can view the agenda and forms we will be reviewing that night.
What do I need to do billing?
In this course we are going to walk through how to use the CMS 1500 and the UBO4 inside the Client Care Midwife EHR system. You will have access to PDF copies of everything we fill out if you plan to file paper claims. Be advised, most insurance companies do not accept paper claims anymore. We will also be walking through the Medi-Cal fee for service website for filing claims as well. I will upload videos on how to fill out each form that you can go back and review when you are ready to start billing. I will also list a few billing systems you can use, as well billers you can contract with to do this for you.
What if I want my biller to attend with me?
You'll get one log in for the course registration. If you have a birth center and would like additional Midwives-or a biller to listen in with their own log in, you can purchase additional log ins for $50 each. Please email us at firstname.lastname@example.org and we will send a separate invoice.
What if I decide after taking your course I don’t want to do Medi-Cal, and would like a refund?
Look, the truth is, that I expect 75% of you to decide not to do Medi-Cal after taking my class. This class is designed to give you realistic expectations. I’m not here to sell Medi-cal to you, quite the opposite. You are not paying for this course to be a Medi-Cal guru, its meant to help you know exactly what its looks like and the real life struggles. You should know what this takes before you are three years deep like me and not able to turn back.
With that said, there are no refunds after the first session begins.