Reimbursement of Nurse Mid-Wives

RICHARD F. CELESTE Governor  STATE OF OHIO # DEPARTMENT OF INSURANCE 2100 STELLA COURT COLUMBUS 43266-0566 BULLETIN 90-4 Reimbursement of Nurse Mid-Wives 1. The Ohio Department of Insurance has received complaints from nurse mid-wives concerning the reimbursement practices of insurers. 2. Insurers are cautioned that they may not apply more rigorous documentation requirements for the bills of nurse mid-wives, or any other limited category of providers, than are required for other categories of providers. 3. Insurers are further cautioned that Ohio Revised Code Section 3923.233 does not require the signature of the consulting physician on a claim form or any other document. It only requires the identification of the nurse mid-wife's consulting physician. 4. Insurers may comply with the requirements of Ohio Revised Code Section 3923.233 by making direct reimbursement to nurse mid-wives. 5. It is an Unfair and Deceptive Trade Practice under the provisions of Ohio Revised Code Section 3901.38 when an insurer denies the reimbursement of claims of nurse mid-wives solely on the basis that the claims have been completed by nurse mid-wives without signatures of other providers. 10-31-90 Date George Fabe Director OHIO Ahead of Life