Yes, that’s right! Labor support services are an expense that can be completely covered through your health care provider, and I’m going to give you the step by step guide on how to get it done.
The tricky business is that private healthcare insurance providers don’t have to cover your claim. Some insurance providers cover some claims and deny others, seemingly at random.
To apply for insurance reimbursement of doula services, follow these steps:
Pay your doula in full, and ask for an invoice. The invoice should include:
- Doula’s name and address
- Doula’s NPI number
- Taxonomy code 374J00000X for Doulas
- CPT code 99499 for Labor Support.
- Diagnosis code V22.2 for Intrauterine Pregnancy or V24.2 for Routine Postpartum Follow Up
- Client Name
- Location and date services were provided
- Total fee for services, including payment dates and methods
- Doula’s signature
Submit the invoice with a claim form to your insurance company or flexible spending account company’s claim department..
Within a month, you should receive a response. If they deny your claim, they will likely tell you either that they need more information before they can process your claim, or that this is not a covered expense.
Do not be discouraged if this is the case. Prepare a new packet to resubmit to your insurance company for a secondary review, and copy everything in the packet to the insurance company’s CEO explaining why you feel services should be covered. In this packet, you should include the following:
- A second copy of the complete invoice
- A letter from you to the CEO explaining why you think you should be covered, as well as why you felt the need for a Doula and how the Doula was beneficial to your health.
- A letter from your physician or nurse explaining how your doula assisted you.
- Your doula’s certifying organization’s Code of Ethics and/or Standards of Practice.
- This information on the benefits of insurance coverage from Childbirth Connection.
- Ask your Doula to send you the following and include in your packet:
- A copy of her certification or training
- Other credentials or relevant experience
- A letter detailing her qualifications, and what services she provided to you.
If they refuse the claim a second time, write a letter to Health Services requesting that they review the claim, as you feel it was beneficial to your health.
Be persistent. Make phone calls if necessary. If they refer to your policy, ask them exactly what clause and what wording in your policy excludes Doula Services and Childbirth Education. They may not pay your claim, but they will consider it for the future.
The following is a partial list of insurance companies have reimbursed in whole or in part for doula services:
Blue Cross/Blue Shield
Blue Cross/ Blue Shield PPO
Foundation for Medical Care
Glencare Managed Health Inc.
Great-West Life & Annuity Ins. Co.
Humana Employers Health
Lutheran General Physician’s Organization
Summit Management Services, Inc
Let me know if you are successful in claiming your Doula expenses! For more information on Doula Services in Hampton Roads, Click Here.
Leave thoughts and questions in the comments, or send me a message.