Requesting Insurance Reimbursement for Doula Services
_____ Pay your doula in full.
_____ Ask her to provide you with the following information:
- An invoice that will include my name and address, social security
number, the date and location services were provided, the CPT code for the
services provided, a diagnosis code, and my signature.
- A copy of the doulas training certificate
- A letter detailing from me to your insurance company detailing my
credentials and relevant training, as well as, my experience and what we did
for you
_____ Submit the above materials along with an invoice and insurance claim
form (provided by the insurance company- most are available online)
to your insurance company. If you have not yet birthed, we would also
recommend asking your care provider to write you a prescription for
doula services that you can include a copy of, in which they should
state:
"________________ is under my care for pregnancy, due on or about . This will be her first baby. Pregnancy has been
uncomplicated. [Or list complications - VBAC, previous vacuum
extraction, epidural, whatever]
I have advised her to engage a professional birth assistant for home
care before and after the birth and for labor support in the
hospital.
I have recommended , who is a professional
certified childbirth assistant and a Certified Childbirth Educator.."
I feel that this support is medically necessary because of her desire
to have a non-medicated birth and because of limited nursing support
in the hospital."
_____ Within 4 weeks, expect a letter telling you either that:
- They need more information before they can process your claim
-or-
- This is not a covered expense.
_____ If possible, ask your obstetrician or midwife for a letter explaining
how I helped you as a doula, 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?) Most care providers are happy to
do this for you and will have an admin prepare it for them to sign
and send out to you.
_____ Write a brief 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 Rx letter from the doctor
- Your cover letter
_____ If they refuse it, write another brief 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.
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