Some insurance companies have covered doula expenses in the past. Especially if you can show the you avoided an epidural (around a $1400 cost), c section, or you were a a VBAC (vaginal birth after cesarean). While I don't bill insurance directly, I will provide necessary forms and do all that I can to help you in the process.
Third Party Reimbursement
How to Request Insurance Reimbursement for Doula Services Created: 1998 © DONA International Last Revised: 12-02-09 Permission granted to reproduce with complete attribution BOD Revision Approval: 02/10 How to Request Insurance Reimbursement for Doula Services Created: 1998 © DONA International Last Revised: 12-02-09 Permission granted to reproduce with complete attribution BOD Revision Approval: 02/10
Pay your doula in full.
Get an invoice from your doula which includes the following information:
the doula's name and address the doula’s NPI number (National Provider Identification)
the doula’s social security number or taxpayer ID number the date and location services were provided the CPT (Current Procedural Terminology) code for the services provided a diagnosis code (which may need to be supplied by your doctor or midwife) the doula's signature
Submit the invoice with a claim form (provided by your insurance company, or the 1500 universal claim form if required) to your insurance company.
the doula's name and address the doula’s NPI number (National Provider Identification)
the doula’s social security number or taxpayer ID number the date and location services were provided the CPT (Current Procedural Terminology) code for the services provided a diagnosis code (which may need to be supplied by your doctor or midwife) the doula's signature
Submit the invoice with a claim form (provided by your insurance company, or the 1500 universal claim form if required) to your insurance company.
the doula's name and address the doula’s NPI number (National Provider Identification)
the doula’s social security number or taxpayer ID number the date and location services were provided the CPT (Current Procedural Terminology) code for the services provided a diagnosis code (which may need to be supplied by your doctor or midwife) the doula's signature
Submit the invoice with a claim form (provided by your insurance company, or the 1500 universal claim form if required) to your insurance company.
the doula's name and address the doula’s NPI number (National Provider Identification)
the doula’s social security number or taxpayer ID number the date and location services were provided the CPT (Current Procedural Terminology) code for the services provided a diagnosis code (which may need to be supplied by your doctor or midwife) the doula's signature
Submit the invoice with a claim form (provided by your insurance company, or the 1500 universal claim form if required) to your insurance company.
the doula's name and address the doula’s NPI number (National Provider Identification)
the doula’s social security number or taxpayer ID number the date and location services were provided the CPT (Current Procedural Terminology) code for the services provided a diagnosis code (which may need to be supplied by your doctor or midwife) the doula's signature
Submit the invoice with a claim form (provided by your insurance company, or the 1500 universal claim form if required) to your insurance company.
the doula's name and address the doula’s NPI number (National Provider Identification)
the doula’s social security number or taxpayer ID number the date and location services were provided the CPT (Current Procedural Terminology) code for the services provided a diagnosis code (which may need to be supplied by your doctor or midwife) the doula's signature
Submit the invoice with a claim form (provided by your insurance company, or the 1500 universal claim form if required) to your insurance company.
Within four (4) weeks, expect to receive a letter telling you either that: they have accepted the claim they need more information before they can process your claim this is not a covered expense If the insurance company needs more information or denies your claim: Ask your doula to send you the following:
a copy of her certification (if she is certified) other credentials or relevant training a letter detailing her training and experience and how she served you
If possible, ask your doctor or midwife for a letter explaining how a doula helped you, was necessary or saved the insurance company money. (Did you have a high-risk pregnancy or postpartum? Did the birth doula's presence and/or suggestions appear to prevent complications, help your labor to progress more quickly or decrease your need for expensive pain medications? Did the postpartum doula’s presence and/or suggestions help you or your baby in the postpartum period, increase breastfeeding success or appear to prevent postpartum complications?)
a copy of her certification (if she is certified) other credentials or relevant training a letter detailing her training and experience and how she served you
If possible, ask your doctor or midwife for a letter explaining how a doula helped you, was necessary or saved the insurance company money. (Did you have a high-risk pregnancy or postpartum? Did the birth doula's presence and/or suggestions appear to prevent complications, help your labor to progress more quickly or decrease your need for expensive pain medications? Did the postpartum doula’s presence and/or suggestions help you or your baby in the postpartum period, increase breastfeeding success or appear to prevent postpartum complications?)
a copy of her certification (if she is certified) other credentials or relevant training a letter detailing her training and experience and how she served you
If possible, ask your doctor or midwife for a letter explaining how a doula helped you, was necessary or saved the insurance company money. (Did you have a high-risk pregnancy or postpartum? Did the birth doula's presence and/or suggestions appear to prevent complications, help your labor to progress more quickly or decrease your need for expensive pain medications? Did the postpartum doula’s presence and/or suggestions help you or your baby in the postpartum period, increase breastfeeding success or appear to prevent postpartum complications?)
a copy of her certification (if she is certified) other credentials or relevant training a letter detailing her training and experience and how she served you
If possible, ask your doctor or midwife for a letter explaining how a doula helped you, was necessary or saved the insurance company money. (Did you have a high-risk pregnancy or postpartum? Did the birth doula's presence and/or suggestions appear to prevent complications, help your labor to progress more quickly or decrease your need for expensive pain medications? Did the postpartum doula’s presence and/or suggestions help you or your baby in the postpartum period, increase breastfeeding success or appear to prevent postpartum complications?)
a copy of her certification (if she is certified) other credentials or relevant training a letter detailing her training and experience and how she served you
If possible, ask your doctor or midwife for a letter explaining how a doula helped you, was necessary or saved the insurance company money. (Did you have a high-risk pregnancy or postpartum? Did the birth doula's presence and/or suggestions appear to prevent complications, help your labor to progress more quickly or decrease your need for expensive pain medications? Did the postpartum doula’s presence and/or suggestions help you or your baby in the postpartum period, increase breastfeeding success or appear to prevent postpartum complications?)
a copy of her certification (if she is certified) other credentials or relevant training a letter detailing her training and experience and how she served you
If possible, ask your doctor or midwife for a letter explaining how a doula helped you, was necessary or saved the insurance company money. (Did you have a high-risk pregnancy or postpartum? Did the birth doula's presence and/or suggestions appear to prevent complications, help your labor to progress more quickly or decrease your need for expensive pain medications? Did the postpartum doula’s presence and/or suggestions help you or your baby in the postpartum period, increase breastfeeding success or appear to prevent postpartum complications?)
Write a letter explaining why you felt the need for a doula and how you believe the doula was beneficial to your and your baby’s health.
Submit to your insurance company: the doula's letter and credentials the letter from your doctor or midwife your cover letter
If they refuse your claim, write a letter to your insurance company to the attention of Health Services requesting that they review the claim, as you feel it was a cost-cutting measure and they should cover the expense.
Follow up by telephone if necessary.
If the insurance company continues to deny your claim, write a letter to the company CEO explaining why you feel that doula care should be a covered expense. They may not pay your claim, but they may consider doing so for future claims.
