How to Get Started with Reimbursement in 2022

Understanding the Billing Process will help you receive proper payments from health insurance carriers. Each insurance carrier has different billing rules. Doulas who haven't done this will receive NON-PAYMENT for services.

Here's how you can get started:

  • Verifying patient eligibility, to ensure you get paid for each date of service.

  • Some states require patients to receive a referral from their health care provider ( MD, Midwife, Nurse Practitioner) for your Doula services. Please be sure to have this documentation in the patient chart.

  • Place of service ( a big one you must know). Where are the services rendered (patient home, office, doctor's office)?

Required for Reimbursement I've seen Doulas run into Denied Claims when they haven't done this:

We know the challenges Doulas may encounter during the billing process, so of course, we cover coding in our Medical Billing for Doulas Training. You must have a CPT and Diagnosis ( ICD-10) code for each date of service you are seeking to receive reimbursement for. You can never bill one without the other. It's important to know the exact service codes for services rendered. If not, your claim will be denied, and will be required to resubmit your claim(s). Claim resubmission may take up to 45 days. Clean claims are always best to avoid this process. Now, do you want to delay your cash flow?

Forgetting Documentation Requirements can Return Revenue

In conjunction with ensuring you have the correct service codes, you must have documentation to support your code selection. Documentation is very important and is key to receiving reimbursement for your services. You may receive an audit at any time from any health insurance carrier. No documentation, you will be responsible to return the monies back to payers. In our Medical Billing training for Doulas, we teach you how NOT to do just that. Now, who wants to return money? No one.

Performing the billing process, requirements for reimbursement, and documentation requirements will help you receive reimbursement from health insurance carriers and learn the medical billing process. P&C provides a Medical Billing for Doula training to educate Doulas on the billing process and the tools, to ensure you receive reimbursement for each date of service. Click below to join our email list and receive a free copy of the 5 billing tools for medical billing.