Bright Steps Program

Maternity Services

Did you know that a doula can support the work you do with pregnant patients by providing non-medical support? Read below for answers to frequently asked questions about doula services or call CalOptima Health’s Provider Relations department at 714-246-8600.

Does a member receiving doula services impact provider services/billing claims?
No. Doula services are a separate benefit to CalOptima Health Medi-Cal members and have no impact on medical provider billing services.

What documentation is required from providers for a member to obtain doula services?
A written recommendation. The recommending licensed provider does not need to be enrolled in Medi-Cal or be a network provider within the beneficiary’s managed care plan. The initial recommendation can be provided through the following methods:

What is the benefit of my members having a doula?
Members will be provided with evidence-based support services outside of the typical medical services. Doula services are aimed at preventing perinatal complications and improving health outcomes for birthing people and infants. If members choose, doulas are a great option to offer additional support during and after pregnancy.

How can doulas become eligible and approved to provide services under Medi-Cal?
Doulas should refer to the Department of Health Care Services (DHCS)
program guidelines and requirements for information on becoming certified and qualified to provide doula services under Medi-Cal.

Step 1 Doulas must use the DHCS Provider Application and Validation for Enrollment (PAVE) portal to submit their Medi-Cal enrollment application. Additional requirements include completing training programs and/or meeting specific experience and education requirements and complying with program standards and regulations. Additionally, all doulas must be at least 18 years old, have a current CPR certification and have completed Health Insurance Portability and Accountability Act (HIPAA) training prior to enrollment.

Step 2 To provide services to a CalOptima member in Orange County, doulas will need to contract with CalOptima Health and its delegated health networks. For information on contracting with CalOptima Health, please contact
doula@caloptima.org.  

What Doula services are covered?
An initial visit, up to eight additional visits in any combination of prenatal and postpartum, support during labor and delivery, and up to two extended postpartum visits.

What services are not covered?
Belly binding, birthing ceremonies, group classes on babywearing, massage, photography, placenta encapsulation, shopping, vaginal steams and yoga. Additionally, doula services do not include diagnosis of medical conditions, medical advice or any type of clinical exams or procedures.