Welcome to Loula! This guide will help clarify the credentialing process with Loula. Credentialing with Loula will ensure that we can support you through the medical billing process and all other health insurance support.
What is Credentialing?
Credentialing is the process through which Managed Care Plans (MCPs) verify that a provider, like a doula, is qualified to deliver services to their members. For doulas, this involves collecting essential information such as:
Personal Information: NPI (National Provider Identifier), SSN, address, professional liability insurance, Medicaid/Medi-Cal enrollment letter, etc.
Training Documentation: Certificates from your doula training program, CPR certification, HIPAA training, etc. We walk you through all of the necessary materials during Loula's onboarding process.
What It Means to be Credentialed with Loula
Being credentialed with Loula allows you to see clients under various managed care plans with streamlined support and consistent twice-monthly reimbursements.
The Credentialing Process
Credentialing with Loula occurs through our onboarding portal. You'll only need to submit your information once to be credentialed with multiple Managed Care Plans (MCPs).
Gather Your Documentation: Collect the necessary credential documents outlined in the portal.
Submit Your Information: Enter your personal details and training documentation into the onboarding portal, ensuring all required fields are complete. After completing your profile, the Loula team will notify you within 30 days with approval of your materials or requests for additional documentation.
Review by MCPs: Once submitted, the Loula team will forward your credentialing documents to your selected Managed Care Plans. The MCPs will review your information, and the Loula Team will work with them to address any issues. This process typically takes 6 to 12 weeks but may extend up to 6 months, depending on the MCP and the need for additional credentialing materials.
Patience is Key
The credentialing process requires patience, as there may be follow-up requests for additional information. Rest assured, our team at Loula will handle most of the communication with MCPs on your behalf, so you can focus on delivery the best quality care to your doula clients.
Want to know your current credentialing status with a health plan? Go to the Credentialing page.
FAQs
Which insurance plans can I credential with through Loula?
Loula is currently credentialed with several large payers across California including Health Net, Kaiser, San Francisco Health Plan, Health Plan of San Mateo, Santa Clara Family Health Plan, and more. If you're interested in learning which plans in your areas are partners with Loula and becoming credentialed through Loula, please check out the Credentialing page in the Loula portal, which you can find on the lefthand navigation bar on Desktop, or your top navigation bar on Mobile. Then, click into Explore/Request plans to use our Health Plan Directory to learn more.
In order to work with Loula's insurance partners you must meet all of the Medi-Cal doula requirements and be enrolled as a Medi-Cal provider.
How long does it take to be credentialed?
This is health plan dependent, but once our team receives your completed onboarding packet, your credentialing can take between 6 to 12 weeks. We do everything we can to expedite the process and will always reach out if there is any additional information we need from you! You will likely not be credentialed with every health plan you choose to work with all at once. Different plans have different timelines. Before you begin visits with a client, be sure that your credentialing with their health plan is complete.
I've already been credentialed with one or some of these payers. Shouldn't that make this process go faster?
No, in general your past credentialing history will not have an impact on your credentialing timeline.
How will I find out when I'm credentialed?
You will receive an email from our team once your credentialing for a particular plan is complete! This email will include the date on which you can begin seeing in-network clients with the payers you've been credentialed with with. This is also the date that Loula can start submitting claims on your behalf.
How can I view or manage my credentialing?
Log into your Loula portal, go to the home screen, and look for the Credentialing page on the left toolbar. Here you will see your selected managed plans, your credentialing status, and your credentialing timeline/start date for each plan. If you click “Explore/Request plans,” on the top right of the page, a plan directory will pop up where you can request new plans or request to join a waitlist.
Need Help?
We’re here for you! If you have any questions or need clarification on any part of this process, feel free to reach out to us at [email protected].