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Doula End-to-End Process

Click on the steps to view the process workflow for Doula services.

Doula process step 1

The member must be active and enrolled in the Medi-Cal Plan. Confirm member eligibility for the month of service through either of the following:

  • Provider portal (preferred method). Log in to the secure provider portal, then select Eligibility.
  • Automated Eligibility Verification System: 800-456-2387
    The Automated Eligibility Verification System (AEVS) is available from 7:00 a.m. to 8:00 p.m., seven days a week. To access this automated network, providers will need their Medi-Cal Provider Identification Number (PIN).

If you are a provider who currently does not have access to the portal, refer to the below brochure for instructions on how to register:

Doula process step 2

Doulas will contact members to schedule an appointment.

Doula services include personal support to women and families throughout a woman's pregnancy, childbirth, and postpartum experience. This includes emotional and physical support, provided during pregnancy, labor, birth, and the postpartum period.

Refer to the CS workflow to identify member needs and confirm if they qualify for Community Supports services.

Doula process step 3

Follow these steps:

Doula process step 4

If the member qualifies for CS services, refer to the CS workflow for referral information.

Doula process step 5

Recommendation – Additional visits during the postpartum period require a recommendation. A doula may facilitate obtaining recommendation from any licensed practitioner for the member.

We will accept either Health Net or DHCS forms:

Doula process step 6

Document doula services and put in the member medical record. Be prepared to present documentation to DHCS or Health Net, if requested. Use the form:

Any documentation format that meets DHCS documentation of services requirements will be accepted.

Doula process step 7

Providers can bill through claims submission or invoice submission. Note: if you submit claims, you won't have to submit an invoice and vice-versa.

Submit claims or invoice forms and supporting information to one of these options:

Note: All visits are limited to one per day, per member. Only one doula can bill for a visit provided to the same member on the same day, excluding labor and delivery. One prenatal visit or one postpartum visit can be provided on the same day as labor and delivery, stillbirth, abortion or miscarriage support. The prenatal visit or postpartum visit billed on the same calendar day as birth can be billed by a different doula.

The extended three-hour postpartum visits provided after the end of pregnancy do not require the member to meet additional criteria or receive a separate recommendation. The extended postpartum visits are billed in 15-minute increments, up to three hours, up to two visits per pregnancy per individual provided on separate days.

Billing training

To learn more about how to bill for doula services, refer to the Claims and Invoice Guidance training.

Note: The training deck is available after viewing the training video.

Last Updated: 03/20/2024