Using your Carrot Benefits? Here’s the latest.

Navigating Doula Care Benefits: How to Find a Doula That Takes Your Benefits and What Providers Need to Know

In recent years, the availability of pregnancy care benefits through employers has seen significant growth. According to a 2022 report by Mercer, 61% of Americans now have access to some form of fertility or pregnancy benefits. However, navigating these benefits—whether you’re a parent seeking care or a doula providing services—can be complex. This blog aims to clarify how to find a doula that aligns with your benefits and offers insights for doulas on supporting clients with benefit reimbursements.

We’ll focus on Carrot Fertility, and respond to their recent changes in pre-approval that took place July 14, 2024 when they switched from a manual, wet signature requirement to an online portal for doula providers to complete their attestation process.

Finding a Doula That Accepts Your Benefits

Which Employers Offer Doula Benefits?

Major employers like Walmart, CVS, Target, and Alina Health have pioneered the trend of offering doula care benefits. Additionally, many companies are partnering with platforms such as Maven and Carrot Fertility to provide a broad range of reproductive health services, including doula care.

We encourage you to ask your employers about benefits and if your company participates in Carrot Fertility, to learn more about your specific benefit coverage. 

Start Your Search Early for a doula

Given the variation in benefit plans, and the complexity of sorting through doulas who may or may not meet your plan’s specifications,  it’s crucial to begin your search for a qualified doula early. Finding and reserving care by 20-27 weeks not only improves your odds of finding care in your area with your best fit, but also provides you with a support system early on that is associated with improved outcomes.  

What doula Services Are Covered?

Carrot Fertility offers coverage from infertility to menopause, with services related to pregnancy and postpartum, that include labor doula care, postpartum support, and bereavement services. 

Care within the doula scope of practice is accepted but non-direct care tasks, such as household support and meal preparation, as well as sibling care, is typically excluded. It’s essential to understand the scope of your benefits and confirm that your chosen doula’s contractual agreements align with these guidelines.

Choosing the Right doula Provider

Carrot Fertility requires that doulas providing reimbursable services hold current certifications relevant to the care they offer. This includes certifications for full spectrum, birth, postpartum, or bereavement doula services. Note that a single doula cannot provide both labor and postpartum care under the same benefit plan. Make sure your provider meets these criteria to avoid issues with reimbursement.

While some benefits plans, Medicaid and insurance plans specify which training organizations are acceptable (and to add to complexity, they all vary), Carrot Fertility does not at this time appear to restrict what Certifying bodies are eligible. As long as your doula trained with and is actively Certified by a training program aligned with the services they are delivering, it should be adequate.

To qualify for coverage, postpartum doulas must attest that they do not perform labor support or are otherwise not on-call for other clients, and are not working with more than one other provider to deliver the intended care package.  If you’re getting labor support as well as day or overnight care, you wouldn’t be able to work with one provider who delivers both your labor and postpartum support. 

Tips for Doulas: Navigating the Reimbursement Process

Understanding Benefit Requirements

As a doula, ensuring you meet the criteria set by benefits providers like Carrot Fertility is key to supporting your clients effectively. This includes maintaining current certifications and being aware of the specific services covered under the benefit. Providers are required to submit attestation forms and uploading your proof of Certification and other documents via Carrot’s online portal as of July 2024,

What Rate is the reimbursement?

Your client will need to learn from their employer what is covered and the limits of their plan. It’s important to know that the rates submitted to Carrot must align with your publicly posted rates. Consider how you position your fee structures on your website, especially if you offer sliding scale rates. You may have been willing to take one or two client a year at a loss, but it’s important to check how you’re framing your pricing. Carrot does recognize that there are regional differences in rates.

They’ve added a line in the attestation that tells you to exclude ‘agency fees.’ We’re awaiting a response to Carrot to clarify this.

Supporting Your Clients with Documentation

Doulas should be prepared to provide clients with itemized statements after services are rendered, detailing the exact dates of care. This documentation is necessary for clients to receive reimbursement and should align with standard health benefit requirements.

Do you have your NPI number or an EIN? Have this available when you complete the attestation and be sure that your name matches on your Certificate, your NPI/EIN and your attestation. Delays are frustrating for your clients but we recognize that you’re also busy taking care of them instead of billing tasks! Remember to communicate your timelines and availability to respond to non-emergent but time sensitive requests.

Final Thoughts

Navigating the complexities of doula care benefits, both as a careseeker and a provider, can be challenging. However, understanding the specific requirements and preparing in advance can make the process smoother.

Here’s how Okkanti helps pregnant and parenting people find vetted care while optimizing their benefits:

Okkanti closes the gap between you, your trusted doula care and other whole-health support providers, and the payers.

Are you looking for a doula in your area that is eligible for your benefits? Let us help! You can go directly to the CareFinder or send us a request to learn about services in your area so that we can filter our vetted providers for your due date, your benefits plans, your cultural identities, and key priorities.

Okkanti supports independent providers to better serve you by addressing these and other billing challenges and everyone communicates in a secure environment to get you seamless care when you most need it!

Here’s how Okkanti helps doulas:

If you’re a provider delivering support to pregnant and parenting people, Okkanti is here to support you so that you can serve your communities!

The opportunities to build access for all pregnant and parenting people to care that saves lives and impacts outcomes are exciting but the pressures and logistics for our small, independent organizations increase our unbillable time.

An Okkanti Community Partner who asked us about Carrot, had more than 30 email exchanges surrounding the process with a single client. These are among the issues we’re working to solve.

When you join our network, Okkanti provides you with the tools you need to serve your community without burning out. Whether you want to learn how to get an NPI number, form a collective, or want to use our free or low cost HIPAA-compliant practice solution, Okkanti has you covered.

Apply to claim your free listing and exclusive invitations to free learning events, office hours and mentor sessions that tackle these and other issues impacting our industry.