Yes, the billing is no problem; we are very familiar with billing according to seasonal per diem rate changes, early baby arrivals, late arrivals, EFM multipliers, and sudden changes of plans. We simply revise our agreement to reflect the updated information (e.g. extended stay due to twins etc.) and you re-sign it.

Travel Advance:

You have the option of applying for a DOS travel advance (OB Med clients, see the New Parent Guide P.52 at https://www.state.gov/wp-content/uploads/2023/09/Combined-New-Parent-Guide_June-2023-Accessible-September-2023.pdf ):

“Before leaving for your medevac, you can apply for an advance of per diem through your post’s Financial Management Office (FMO) using a copy of your fiscal data cable (the funding cable) issued by MED/FP.  You may also apply for an advance upon your arrival in Washington, D.C.  If you travel on medevac to any location other than Washington, D.C., including an overseas medevac location, you will not be able to apply for an advance once you depart post. Birth parent and dependent minor children are eligible for travel advance of 80 percent of per diem, transferred electronically to the employee’s account.  The total amount advanced may not exceed 80 percent of the estimated expenses for more than 45 calendar days of travel status.”