Are you asking your clients if they are insured with two health plans?
If they are, do you know what to do? Hint: you can't just choose the one that covers the benefit.
Doula Insurance Billing & Credentialing, Nationwide
For doulas who bill insurance or want to start. We handle the business side of reimbursement so you can focus on families.
How we support you
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Payer enrollment, contracting & credentialing
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Eligibility verification
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Coding & claim submission
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Consulting
Doula billing is easy, right? Not quite…
You've FINALLY enrolled with your first payer. Whew! You've read through your contract and you have a good understanding of how to submit a claim. Maybe you've even signed up for a web-based doula billing platform, and you're feeling confident that you can do this yourself. A few things to consider:
Are you checking each client's insurance plan to ensure doula services are covered AND the policy is active prior to services being rendered?
Are you familiar with how deductibles, coinsurance, and copays work, and whether those apply to your client?
Even in states with mandates that don't allow cost sharing, this can be something you'll need to understand and be prepared to collect. Some plans aren't required to follow state mandates.
If you're providing telehealth services, are you using a compliant technology platform, and do you know what to document for these types of services to ensure you're compliant with telehealth guidelines?
Are you confident your documentation practices substantiate services rendered and will stand up to health plan review?
Are you creating HIPAA-compliant processes for collecting PHI from your clients?
Doulas who only accept private pay aren't subject to HIPAA. Once you accept insurance, HIPAA compliance becomes mandatory.
Do you know how to tell the difference between an in-state Blue Cross Blue Shield health plan and an out-of-state plan, and why this matters to you?
Do you understand how to read your Electronic Remittance Advice (ERA) from your contracted payers?
Do you know how to price your self-pay and insurance-based services correctly to ensure you're compliant with payer contracts?
Do you know when you need to use a modifier on your claim and when you don't?
Do you know where to look on your payer websites in case anything changes?
If you answered "no" or "I'm not sure" to any of these, you don't have to figure it out alone.
Let's TalkFrequently Asked Questions
Do you work with doulas in my state?
We have extensive experience with all of the national payers. RevCycle Rx has executed Medicaid enrollment in Rhode Island, Massachusetts, Connecticut, and Florida. We are currently looking to expand our Medicaid knowledge, and are welcoming doulas nationwide to inquire. Doula coverage and billing rules vary by state and payer, so we take what we already know about how Medicaid works, and research your particular state and region's guidelines and process requirements as part of your onboarding. We all start somewhere! Welcome aboard.
How long does it take to start billing insurance?
Payer contracting and credentialing often take several months, depending on the payer and state. The sooner we start, the sooner you can bill.
Do you work with private-pay doulas?
We don't manage billing for fully private-pay clients.