While some hospitals and birthing facilities offer doulas at no cost to expectant couples, most couples do have to pay for their own doula. This means, due to financial concerns, many couples who need a doula are not able to get one. On the doula side of it, doulas are not charging what they’re worth as they try to keep rates affordable for their clients. However, there is a solution—many insurance companies will reimburse doula services, if you know how to get it.
Your insurance company does not cover doula services; they may reimburse you for the doula fee. This means you have to pay your doula first before you can get reimbursement. Therefore, you have to pay her. Let her know you’re asking your insurance company for reimbursement—she may have tips to help you get it.
Get your doulas National Provider Identification Number (NPI) from the National Uniform Claim Committee (NUCC). While doulas do not need to be a certified doula at this time to get this number, that will probably change quickly. If you’re a doula, the new taxonomy code is 374J00000X and is called “Doula” under the heading of “Nursing Service Related Providers Type”. You do not need to be a nurse to get this code.
If your insurance company accepts your doula’s NPI number, you will want to send it in along with a 1500 Universal Claims form. You will need your doula’s invoice to do this. If you’re having problems with your insurance company, DONA International suggests sending in your doula’s invoice with a letter explaining what a doula is and how they reduce costs.
You may also need to include the proper diagnosis codes. This article from Gentle Birth.org includes the most common codes for doula services. This article also includes a sample invoice with the codes to help you out.
Many couples are finding their insurance company initially rejects the claim. You will have to resubmit it repeatedly, probably with additional information. The good news is that more and more people are getting insurance reimbursement—the more people who get it the less time this process to likely to take. DONA has a sample letter (click here to see) to send in to the insurance company if the initial claim is rejected.
Have you gotten insurance reimbursement? Let us know how you did it and how easy (or hard) it was.
The information in this article is not medical advice. This information is not meant to treat, diagnose, prescribe or cure anything during your pregnancy, birth, or postpartum time. Always check with your care provider before following any advice from TheOnlyBabyStop.com.