New Arrival Educators

Prenatal Class Completion and Insurance Reimbursement Letter



Name_______________________________________________________________________

Class Type___________________________________________________________________


The above client attended a prenatal education class and paid tuition in full. Tuition covers one pregnant client and one partner/support person. If the client attends alone, the tuition remains the same.


Authorized Administrator: Margaret Breen RN, MS, CCE

New Arrival Educators Tax ID # 46-4654405


Subscriber’s Name_______________________________________________________________

Policy Number__________________________________________________________________


NOTE: This form must be accompanied by proof of payment such as, a copy of your New Arrival Educators’ class receipt that was emailed to you to confirm your payment and registration in the class or a copy of your credit card statement. We recommend making a copy of this form for your records before submitting to your insurance company. Also, be sure to submit the following applicable CPT codes (required by most insurance providers). Check with your own insurance company regarding your prenatal education reimbursement benefits and other possible requirements.


*CPT Codes for prenatal class attended______________________________________________


*CPT CODES

S9436: Childbirth Education/Lamaze Classes, non-physician, per session

S9442: Birthing Class, non-physician, per session

S9443: Lactation Class, non-physician, per session

S9444: Parenting Classes, non-physician, per session

S9447: Infant Safety (including CPR Classes), non-physician, per session




New Arrival Educators, LLC

www.NewArrivalEducators.com

P.O. Box 1254 Duxbury, MA 02332

1.844.207.0918