Doulas and Insurance
I have great news! I now have a National Provider Identifier number.
What is that, you ask? The NPI is the identifier that identifies me as a health care provider and allows you to file for reimbursement from your health insurance plan. Yes, you read that correctly! You may be able to get some or all of my fee back from your insurance company!
How do we do this?
Here is a great instructional resource from DONA:
How to Request Insurance Reimbursement for Doula Services
_____ Pay your doula in full.
_____ Get an invoice from her which includes the following information:
a. The doula's name and address
b. Her social security number or taxpayer ID number c. The date and location services were provided
d. The CPT code for the services provided
e. A diagnosis code
f. The doula's signature
_____ Submit the invoice with a claim form to your insurance company.
_____ Within 4 weeks, expect a letter telling you either that
a. they need more information before they can process your claim.
b. this is not a covered expense.
_____ Ask your doula to send you the following:
a. a copy of her certification (if she is certified)
b. other credentials or relevant training
c. 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.
(c) Kelli Way, ICCE, CD(DONA) 1998 Permission granted to reproduce with complete attribution.
Even if the insurance company does not pay you anything, you can still pay my fee from your Health Savings Account or from your Flexible Spending Account!