Check out the full details of the curriculum below, but here are the...
Learning Objectives:
- Understand the categories of potential payors
- Explain the current overview of doula coverage by Medicaid, private insurance, health shares, and medical savings accounts
- Learn common requirements for credentialing as a doula
- Discover how to find out if an insurance policy covers doulas
- Understand ICD-10, CPT, and POS codes
- Demonstrate how to file doula claims using a CMS-1500
Course curriculum
-
01
Welcome!
Show details- Introduction and Overview
- PDF: Glossary Of Insurance Definitions
-
02
Doula Coverage By Insurance and Other Payors
Show details- Overview of Potential Payors
- PDF: Primary and Secondary Coverage Chart
- Doula Coverage by Insurance and Other Payors
- Resources
-
03
Credentialing Requirements
Show details- Credentialing Overview and Malpractice Pros and Cons
- NPIs
- National Plan and Provider Enumeration System Walkthrough
-
04
Coverage Verification and Claim Submission
Show details- Verifying Insurance Benefits
- Coding and Claim Submission
- All About the CMS-1500
- How to Complete a CMS-1500
- Red CMS-1500 Form (HCFA)
-
05
Medicaid Resources
Show details- Florida: Aetna Better Health of Florida
- Florida: Humana Healthy Horizons
- Florida: Simply Healthcare
- Maryland
- Minnesota
- Maryland PT 37-22 Coverage of Doula Services for Healthchoice and Medicaid Fee-for-Service Enrollees
- Nevada Medicaid
- New Jersey: Steps for Doulas to Enroll
- New Jersey: FamilyCare
- New Jersey: Horizon NJ Health
- NJ Medicaid Claims
- Oregon Medicaid (OHP) Doula Rates April 2023
- Oregon Medicaid (OHP) Fee-for-Service reimbursement for Community Health Workers
- Oregon Health Plan Claim Submission
- Rhode Island Families Deserve Doulas Certification FAQ
- Rhode Island: Doula Requirements
- Rhode Island: Public Notice of Proposed Amendment - Contains Fee Schedule
-
06
TriCare Resources
Show details- Tricare
- Tricare West
-
07
Private Insurance Resources
Show details- Rhode Island (Private) Health Insurance Coverage Guide
- UCare Doula Payment Policy
-
08
Using a Professional Billing Service
Show details- Questions To Ask Professional Billers
-
09
Course Evaluation
Show details- Evaluation Questions
Jesica Dolin, BSM, CPM
Instructor Bio:
Jesica Dolin practiced in Oregon for about 15 years, and attended over 600 births during that time. In her post-call life, she served three terms on the Advocacy Council of the Oregon Midwifery Council, taught at Birthingway College of Midwifery, and worked as a consultant to several midwifery-related companies. She is the founder of HiveCE, and is now devotes her work time fully to improving midwifery care for clients and midwives through continuing education and research.
