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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.

Did You Know?
Home births have been shown to be safer than hospital birth for healthy moms???
Read more!

We have a secret in our culture, and it's not that birth is painful... it's that women are strong.
- Laura Stavoe Harm

Contact Us at:

info@birthingforlife.com
or 508-668-4247
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