How to Request Insurance Reimbursement for Doula Services

Continuing from my last post on

Wednesday Wow: Paying Your Doula .

Here’s how to file your paper work to get your doula fees paid.

The fact that their insurance company might reimburse at least some portion of the fee for your services might make you attractive to a group of potential clients who might not have been interested before. Getting reimbursement for doula services requires patience and persistence, but it can be done. If you are going to offer this as a possibility for your clients, you will also need to be willing to offer some guidance and, most likely, a fair amount of support, as they attempt to get reimbursed.

blog_DoulasChargeWhatYouAreWorth1.png

 

How to Request Insurance Reimbursement for Doula Services

___     Pay your doula in full.

___     Get an invoice from her which includes the following information:

  1. The doula’s name and address
  2. Her social security number/taxpayer ID number or NPI number
  3. The date and location services were provided
  4. The CPT code for the services provided
  5. A diagnosis code
  6. The doula’s signature

___     Submit the invoice with a claim form to your insurance company.

___     Within four weeks, expect a letter telling you either that

  1. They need more information before they can process your claim.
  2. This is not a covered expense.

___     Ask your Doula to send you the following:

  1. A copy of her certification (if she is certified)
  2. Other credentials or relevant training
  3. A letter detailing her training and experience and what she did for you

___     If possible, ask your obstetrician or midwife for a letter explaining why a doula helped you, was necessary, or saved the insurance company money. (Did you have a high-risk pregnancy? Did the doula’s suggestions appear to prevent complications or help your labor to progress more quickly? Did the doula’s presence decrease your need for expensive pain medications?)

___     Write a letter explaining why you felt the need for a doula and how you believe the doula was beneficial to your health.

___     Submit to your insurance company: the doula’s letter and credentials the letter from the doctor your cover letter

___     If they refuse it, write a letter to Health Services requesting that they review the claim, as you feel it was a cost-cutting measure and they should cover the cost.

___     Follow up by telephone if necessary.

___      If they refuse, write a letter to the CEO explaining why you feel that doula care should be a covered expense. They may not pay your claim, but they will consider it for the future. (Kelli Way, ICCE, CD(DONA) 1998.

 

doula2.jpgNotes:
If you are a doula, I suggest you click over and read the guide to getting a National Provider Number and helping your clients get reimbursed.

Also, here is a pdf from DONA with several FAQ’s on insurance reimbursement

And here’s how to contact me for my birthing services:

The Pink GrassHopper Birth

On Twitter- Doula In Charlotte

FaceBook – Doula In Charlotte

 

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