When you work with insurance, there are some services that are covered and some that aren't.
Generally speaking, these services are covered by insurance:
Developing a birth plan
Health navigation
Evidence-based education and practices
Linkages to community-based resources
Physical, emotional and other non-medical support
Lactation support
Comfort measures, including guidance on breathing, relaxation, movement, positioning during labor
Keep in mind that doulas are non-medical professionals. Medical services must never be provided in your capacity as a doula. This includes:
Diagnosing conditions
Prescribing treatments
Performing vital checks
Administering medication.
Also, there are some services that may be provided in the broader doula world, but are not covered by insurance. This includes:
Belly binding (traditional/ceremonial)
Birthing ceremonies (i.e., sealing, closing the bones, etc.)
Group classes
Massage (maternal or infant)
Still and Video Photography
Placenta encapsulation
Shopping
Vaginal steams
Yoga
What should I do if a client requests these services OR if I want to provide these services?
You may offer or provide these non-medical services as an additional offering outside of the visit you bill for.
You must communicate to the client that these services are being offered outside of what their insurance covers.
We high recommend that if you do offer these non-covered services, you include a clause in the doula-client agreement or contract that acknowledges these services are being provided outside of the visits that are covered by the client's doula benefit.
For example, let's say a client requests belly-binding and you are willing to provide the service. You might go about doing so in the following manner:
You have a standard Perinatal, Postpartum visit, during which you provide covered services like postpartum education and emotional support. This visit takes 30 minutes.
At the end of the 30 minutes, you communicate to the client that the covered Perinatal, Postpartum visit has ended.
Communicate to the client that you will now provide belly-binding pro-bono.
You provide belly-binding. Let's say it take you an additional 30-minutes to do so.
When you come to Loula to submit the visit,
You should submit a Perinatal, Postpartum visit.
You should indicate that the visit duration is 30 minutes.
You should not include belly-binding in your visit notes, as it was not provided within the visit you are billing for.
Can I charge for these services?
You may provide these non-covered services pro-bono or for a fee. That is a decision for you to decide.
However, if you charge for these additional services they must be optional.
You cannot decline to provide covered doula services to a client because the client is unwilling to pay for additional services.