Billing for Midwives

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This course is designed to take you from knowing nothing about insurance, to being able to bill your own claims for doula services.

Check out the full details of the curriculum below, but here are the...

Learning Objectives:

  1. Understand the categories of potential payors
  2. Explain the current overview of doula coverage by Medicaid, private insurance, health shares, and medical savings accounts
  3. Learn common requirements for credentialing as a doula
  4. Discover how to find out if an insurance policy covers doulas
  5. Understand ICD-10, CPT, and POS codes
  6. Demonstrate how to file doula claims using a CMS-1500

  • Jesica Dolin Gutierrez

    Instructor Bio:

    Jesica Dolin Gutierrez had the honor of attending over 600 births in her 15 years spent practicing as a homebirth and birth center midwife. In her post-call life, she served three terms on the Advocacy Council of the Oregon Midwifery Council, taught at Birthingway College of Midwifery, worked as a consultant to midwifery lawyers and software companies, served on advisory boards to the Oregon Health Authority, and volunteered with MEAC as a CE reviewer. She founded HiveCE in 2015, and is devoted to improving care and options for perinatal families and providers through continuing education and research.

    Jesica Dolin Gutierrez

    Midwife and Founder of HiveCE

Course curriculum

  • 01
    Welcome!
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    • Introduction and Overview
    • PDF: Glossary Of Insurance Definitions
  • 02
    Doula Coverage By Insurance and Other Payors
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    • Overview of Potential Payors
    • PDF: Primary and Secondary Coverage Chart
    • Doula Coverage by Insurance and Other Payors
    • Resources
  • 03
    Credentialing Requirements
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    • Credentialing Overview and Malpractice Pros and Cons
    • NPIs
    • National Plan and Provider Enumeration System Walkthrough
  • 04
    Coverage Verification and Claim Submission
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    • 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
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    • 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
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    • Tricare
    • Tricare West
  • 07
    Private Insurance Resources
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    • Rhode Island (Private) Health Insurance Coverage Guide
    • UCare Doula Payment Policy
  • 08
    Using a Professional Billing Service
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    • Questions To Ask Professional Billers
  • 09
    Course Evaluation
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    • Evaluation Questions

Billing for Doulas

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