Insurance coverage of doula services is becoming a more common occurrence in the birthing world. Cocoon Birth encourages you to take the following steps to attempt reimbursement of your doula services through our programs. We are happy to provide you with the necessary documentation to move forward with an insurance reimbursement.
Insurance and Flexible Spending Account Coverage
Some insurance companies will pay for doula services by reimbursing you. You may also submit to your medical flexible spending account (cafeteria plan) to help reduce your costs.
How to get reimbursement for doula services:
1. Pay in full for the doula services provided.
2. Get a receipt from Cocoon Birth, LLC. The receipt will include the following information:
- the doula’s identifying information
- the diagnosis code (V22.2, intrauterine pregnancy)
- the CPT code (99499, Evaluation and Management Services – Labor Support)
- the date and location services were provided
- the mother’s name
- total charge for services
- dates and amounts of payments
- payment method
3. Submit the receipt with a claim form to your insurance or flexible spending account company’s claims department.
4. Within a month, you should receive a response. If you receive a letter denying the claim, 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 (and be sure to point out how much money the insurance company saved because of the services your doula provided, i.e. if you forewent medical pain management because of your doula or feel you avoided other interventions that are costly to insurance providers, such as augmentation of labor or cesarean birth). In this resubmission packet, you should include the following:
5. Be persistent. Make phone calls if necessary. If your claim is ultimately denied, call and ask for a specific reason why. If they refer you to your policy, ask them exactly what clause and what wording in your policy excludes doula services.
6. Whether you are reimbursed or not, please let Cocoon Birth know what kind of response you get from the insurance company. Each time someone requests reimbursement, it tells the insurance companies that this is an important service. They may consider it more carefully next time. If you are reimbursed, this is very good news for doulas and we always want to know!
