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Finance your birth:



Professional Member &
former President of the
Washington Alliance for
Responsible Midwifery




Professional Member of

Oregon Midwifery Council




Professional Member of

Association of Texas Midwives




My logo photo
My logo photo
Highland Midwife
Birth Services, LLC
South Central Washington
& the Columbia River Gorge






baby toes
Fees and Payment


Service Package:

Highland Midwife Birth Services charges a Service Package fee of $4750 for complete routine midwifery care during pregnancy and birth, which is a prompt-pay discount for clients who pay in full by 35 weeks. Below you will find several options to help parents pay for their care. The midwifery care provided under the Service Package meets or exceeds the standards for routine obstetrical care, which costs thousands of dollars more. Further, it includes many services which are not normally offered with ob care. For details please see my Financial Agreement.

    2011 Average Costs of Births in the U.S.*
        Cesarean birth: $24,300
        Vaginal birth: $15,200
    Compare to:
        Home birth: $4,750 with us, which includes your prenatal, gyn, and newborn care.

            *Source: International Federation of Health Plans



Choices for Payment Options
Various options to pay for services with Highland Midwife


These are some of the most common methods of payment used to pay for maternity care, and which can be used in various combinations, with some details of the benefits and drawbacks of each:


1.     Self-Pay Cash

  ♥     Benefits include receiving our prompt-pay discount package fee, a large savings.
  ♥     Simplifies your care; gives you total freedom in your choices, within safety parameters.
  ♥     Requires payment of package fee in full by 35 weeks. This can be done using a Medical Loan (see 5. below).
  ♥     You can still use your private insurance, and we will provide you with an itemized detailed invoice complete with coding. If you hire our biller at the start of care, she can pre-authorize your care, submit claims and appeals to your private insurance policy for you, and all reimbursements come back to you.
  ♥     If you pay us for labs at the time of service, your labs will cost less because we get a provider discount to pass along to you, but we can only offer that savings if we are paid immediately (because we have to pay the lab right away).
  ♥     You can use your credit or debit card to make payments if you need to! Just log into the Silver Sage store, go to "Other Payments", and choose Highland Midwife. Select various amounts to add to your cart until it totals the amount of the payment that you want to make. It is secure, easy, and a printable receipt is automatically generated for you.
  ♥     Some trades will be considered. We do live in a rural agricultural area; items such as firewood, hay, and produce are always welcome! Further; I will always treat gold and silver as legal tender for payment.



2.     Private Insurance

  ♥     May or may not pay what you expect it to pay, after you have paid their large premiums.
  ♥     May leave you owing a significant balance for your “patient responsibility”.
  ♥     May severely limit your options for choices in your own care, depending on the details contained within your written policy, which details are rarely shared with you.
  ♥     Will delay payment of claims, and invariably requires appeals, making you ineligible for a prompt-pay discount package fee unless you elect to Self-Pay (see 1. above).
  ♥     Requires advance payment of biller fees to obtain proper authorization for care.
  ♥     Insurance payments all go to your midwife unless you have overpaid your portion.
  ♥     Gives you the option of paying only your Estimated Patient Responsibility by 35 weeks, which disqualifies you for the package fee but reduces your up-front costs.
  ♥     Lorri will be your contracted midwife, and your claims will not be processed in-network, but an exception can be requested to get in-network reimbursement rates for you.
  ♥     Any amount that you do have to pay should count toward your annual deductible.



3.     Medicaid-based Insurance

  ♥     The midwives at Highland alternate clinic days to insure that you get to meet everyone who may be at your birth, but only one of them will be your contracted midwife and the other will be their backup and/or assistant midwife.
  ♥     Lorri no longer accepts Medicaid, and all services with Lorri are Non-Covered services by any Medicaid-based policy. Your outside services such as labs will still be covered by insurance. Lorri needs to be paid using another option.
  ♥     Rebekah still accepts Medicaid, so if you must use Medicaid, she will be your contracted midwife. Lorri will be her backup, which is still billed under Rebekah and covered by your policy. If you specifically want Lorri to also attend your birth (not as backup but as an additional assistant midwife), she charges a separate cash on-call/assistant fee which is a Non-Covered service.
  ♥     Medicaid will pay Rebekah for basic standard maternity services (at a minimal break-even rate), labs, ultrasound, prescription medications, and any transfer or consult that may be needed. Extra care or services may be Non-Covered by Medicaid, in which case you will not be able to receive them from Rebekah under Medicaid rules, but you are still free to receive them from Lorri and pay with cash if you so desire. Examples: extra visits with Lorri such as nutritional, fertility/hormone, and herbal consults, (doula) support for hospital births, or herbal/vitamin supplements.
  ♥     Lorri will consider, on a case-by-case basis, offering a discount for clients with income-based Medicaid but who elect to have Lorri be their midwife and pay cash instead.
  ♥     If you utilize only basic Medicaid-covered services for your prenatal care, birth, and postpartum, then your only cash out-of-packet expense will be your birth kit of disposable supplies.



4.     Healthshares

  ♥     These are currently the only insurance plans which are actually paying providers up to 100% of their fees. (Others only pay a portion of the billed amount, and expect providers to write off the rest and never be fully paid, or patients to pay the balance.) Experience with healthshares has shown that they offer birthing families extremely good service.
  ♥     There are both Christian-based and non-religious healthshares available. They cost less than other private plans, because they are not paying huge profits to stockholders.
  ♥     The detailed invoice that we provide satisfies their paperwork requirements. We give you an “average” estimate for them at the start of care, so they budget ahead to pay for it. After the birth, we give you a closing invoice with exact amounts, including labs.
  ♥     Requires pre-payment in full by 35 weeks, and labs paid at time of service. A short-term Medical Loan (5. below) can help with that.
  ♥     The prompt-pay in full makes you eligible for the package discount flat fee.
  ♥     Reimbursement is usually very fast, and no far has never required any appeal, and the refund all comes directly back to you.



5.     Medical Loans

  ♥     We are delighted to now be able to offer you this option! You can log into United Medical Credit to sign up under Lorri’s provider account and apply for a personal medical loan to pay for your maternity care. The direct link is posted below - please apply early to determine whether this may be the best option for you.
  ♥     This option qualifies you to benefit from the prompt-pay package fee discount, without any out-of-pocket expense for you.
  ♥     You can still hire Rebekah's biller to handle your private insurance, and/or send in your closing invoice to your insurance or healthshare, and all reimbursements from your claims will come back to you.
  ♥     If you apply for a modest amount above our fee, it can cover your labs and supplies as well. Those usually total between $150 and $350.
  ♥     You control the amount of the loan that you apply for, so if you only need a smaller amount to finish paying your fees, then your loan amount will be minimal and still allow you to get our discounted package fee, which means significant savings for you.


      Thousands of patients have trusted United Medical Credit to secure affordable payment plans for their procedures.
      United Medical Credit can do the same for you.
      Some of the benefits of choosing United Medical Credit to finance your care:
          ◈   Extensive Network of Prime and Subprime Lenders
          ◈   Multiple Plans to Choose From
          ◈   Decisions Within Seconds
          ◈   No Prepayment Penalties with Flexible Terms
          ◈   Fast and Easy Application Process with No Commitment
          ◈   100% Confidential
          ◈   Plans available for Credit Challenged Applicants



Please carefully read your Financial Agreement prior to signing and returning it to us. Consider your options carefully, and ask whatever questions are needed to fully understand the effects of your choices. The Financial Agreement is a binding legal document. Due to the extremely poor pay from insurance since the Affordable Care Act, your midwives now have no alternative but to strictly enforce the terms of the Financial Agreement, and will not be able to continue your care or attend your birth if those terms are not met, so please choose an option (or propose a payment plan) which is practical for you, and with which you are able to comply.

By signing the Financial Agreement, and by initialing your payment choices on our Informed Choices Checklist, you will selecting one or more of the above options to obtain maternity care and birth services.



I reserve my absolute right to refuse to pursue collection actions against clients for whom I believe those actions would induce financial hardship. I also reserve the right to pursue collections or court action against clients who act in bad faith by not paying their agreed debts after they have received care.





Webdesign and content copyright 2009-2017 by Lorri Carr, LM CPM LDM; site maintained by Highland Midwife TM.
Original guardian angel/valkyrie logo designed by Justin Farnsworth; copyright 2012-2017, all rights reserved for Highland MidwifeTM and the artist.
Tree of Life original logo copyright 2017 Highland Midwife TM, all rights reserved.


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