How to get your Insurance Company to reimburse for Doula Services

Here is a list of some insurance companies who have reimbursed in whole or in part for doula services:

• Aetna Healthcare

• Blue Cross/Blue Shield

• Blue Cross/Blue Shield PPO

• Cigna

• Humana Employers Health

• United Health POS

• Medicaid

How to Request Insurance Reimbursement for Doula Services:

1. Pay your doula in full.

2. Get a receipt from your doula that includes the following information:

   • The doula’s name & address

   • The doula’s social security number/taxpayer ID number and/or NPI number

   • Diagnosis Code (V22.2, intrauterine pregnancy/ V24.2, routine postpartum follow up)

   • The CPT code for the services provided ( 99499, labor support/ 99501 and/or 99502, postpartum care)

   • Taxonomy Code (374J00000X)

   • The date and location services were provided

   • The doula’s signature

   • The mother’s name

   • Total charge for services

   • Dates & amounts of payments

   • Payment method

3. Submit the invoice with a claim form to your insurance company or flexible spending account company’s claim department.

4. Within a month, you should receive a response telling you either that:

   • They need more information before they can process your claim.

   • This is not a covered expense.

5. Do not be discouraged. 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 resubmission packet, you should include the following:

   • Another copy of the receipt

   • 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 you believe the doula was beneficial to your health

   • Ask your doula to send you the following and include in your packet:

     1. A copy of her certification (if she is certified)

     2. Other credentials or relevant training

     3. A letter detailing her training and experience and what she did for you

1. If they refuse it, write a letter to Health Services requesting that they review the claim, as you feel it was a cost-cutting measure and they should cover the most.

2. Be persistent. Make phone calls if necessary. If your claim is ultimately denied, cal and ask for a specific reason why. If they refer to your policy, ask them exactly what clause and what wording in your policy excludes doula services. They may not pay your claim, but they will consider it for the future