Birth doulas: Provider enrollment opens August 1

Washington State Health Care Authority sent this bulletin at 07/31/2024 02:00 PM PDT

July 31, 2024

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Doula provider enrollment opens August 1

Following the passage of SB 5950, Sec. 211 (34), the Health Care Authority (HCA) is implementing a birth doula benefit for Apple Health (Medicaid) clients with an anticipated effective date in early 2025.

Beginning August 1, 2024, birth doulas may enroll as Apple Health providers. Enrolling in advance of the early 2025 doula benefit start date is strongly encouraged to prevent delays in provider reimbursement.

Frequently asked questions

What information is needed for the provider enrollment process?

To get started, you will need your:

Personal identifiers such as full name, date of birth, address, phone number, and e-mail address.
Current Department of Health birth doula certificate number.
National Provider Identifier (NPI). See more information about obtaining an NPI.
Provider taxonomy code. The birth doula taxonomy is 374J00000X.
W-9 for federal tax purposes. The W-9 form is required for all providers.
Business license.
Professional liability insurance coverage policy.

You must also upload attachments prior to final submission of your application. A list of required documents will be provided within the enrollment application. Once you begin the provider enrollment process, you have a total of ninety days to complete it, upload attachments, and submit the application.

I work for an established clinic as a doula. My clinic is already enrolled with Apple Health. Do I still need to enroll?

Yes, you will need to enroll as a servicing provider associated with your clinic. Check with your clinic’s billing and/or credentialing staff about becoming enrolled.

How much does provider enrollment cost?

There is no cost to enroll as an Apple Health provider.

How do I get help with my provider enrollment application?

Visit Enroll as a provider for guidance on selecting your provider type and step-by-step written instructions for completing your application.

Provider Enrollment offers phone hours on Tuesdays and Thursdays from 7:30 am to 4:30 pm (closed from noon to 1 pm) at 1-800-562-3022 Ext 16137. Provider Enrollment staff are not able to provide assistance with business-level decisions, such as organizational structure or taxes.

Stay updated

View doulas webpage.
Email the doula program at HCA with questions.
Sign up for doula bulletins from HCA.

About the Health Care Authority (HCA)

Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.

There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention, crisis, and recovery supports to all Washington residents.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.