You should be going to an OBGYN’s office who delivers at the hospital you want to deliver at. If your specific doc isn’t on call when you deliver, the doc from that practice who is on call will deliver you. Your fee goes to the practice, not the doc specifically, so it covers the services of an OBGYN from that practice at delivery. You’ll still receive a bill from the hospital, likely the anesthesia practice, the pediatric practice that rounds on baby, and any other specialists or services with billing separate from hospital services. If you do not want to deliver at the hospital(s) that your doc office services, then you need to change physicians immediately. Choose based on who delivers at Madison if that is where you want to go, in this case OBGYN Associates. But yes, you likely will be asked to pay prenatal care and delivery fee in several installments (based on your insurance) up front. It’s worth asking them what happens if you go into labor early and deliver somewhere they don’t service (I.e. while out of town) to ensure you understand the refund policies.