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Become a Medicaid Enrolled Doula

Pregnant Belly
Department of Health and Human Services

Become a Medicaid Enrolled Doula

Become a Medicaid Enrolled Doula

MDHHS will maintain a Doula Registry to support access to doula services statewide. To be part of the registry, individuals must have completed a MDHHS-approved qualified doula training program.

MDHHS-approved qualified doula training programs or organizations include:

Additional doula programs may be approved by MDHHS working collaboratively with the Doula Advisory Council. Requests for consideration may be sent to MDHHS-MIDoula@michigan.gov

Steps to Enroll as a Medicaid Provider 

Doula providers seeking reimbursement for their professional services to Medicaid beneficiaries are required to be on the MDHHS Doula Registry and enroll as a Medicaid provider. Michigan Medicaid coverage of doula services is published in the bulletin MMP 22-47. Qualified individuals must be at least 18 years of age and possess a high school diploma or equivalent. MDHHS will approve doulas who have completed training provided by an MDHHS approved doula training program or organization. Doulas must provide proof of training to MDHHS upon request. 

Please review the following documents to assist in enrolling as a Medicaid provider:

  • Provider Enrollment - step-by-step instructions for new Doula providers, CHAMPS, providing Medicaid covered Doula services, and more. 
  • Beginner Guide for Doula Providers - contains links to resources to walk you through the processes of enrolling, checking eligibility, and billing a claim. 

Step 1:  Complete an MDHHS Doula Registry Application

Doulas providing services to Medicaid beneficiaries will be required to be registered with the MDHHS Doula Registry to enroll as a Medicaid provider. 

Step 2:  Apply for a Type 1 (Individual) National Provider Identifier (NPI)

Learn more about how to apply for an NPI 

Step 3:  Register for SIGMA Vendor Self-Service (VSS)

Step 4:  Register for a MILogin Account for Access to CHAMPS

Step 5:  Complete an online application in the Community Health Automated Medicaid Processing System (CHAMPS)

All providers who serve Michigan Medicaid beneficiaries are required to be screened and enrolled in the Community Health Automated Medicaid Processing System (CHAMPS). CHAMPS is the MDHHS web-based, rules-driven, real-time adjudication Medicaid Management System. This web-based system allows for the following functions to be completed online: provider enrollment, provider updates, claims status, direct claim entry, batch claim submission, claim adjustments/voids, payment status, prior authorization, eligibility verification, member search, and ordering/referring provider verification.

To learn more about the Medicaid provider enrollment process or to begin enrollment, refer to Provider Enrollment (michigan.gov). New Individual providers can utilize the CHAMPS Enrollment Application: Individual/Sole Proprietor User Guide to complete the CHAMPS application and select the doula specialty. 

Provider Support staff are available to assist prospective and current providers in navigating the CHAMPS system:  

  • Phone: 1-800-292-2550 option 4. 
  • Email: Providersupport@Michigan.gov
  • Monday through Friday 8:00 am to 5:00 pm EST. Closed on all State and major holidays.

After enrolling in CHAMPS, a doula may provide services to fee-for-service ("straight Medicaid") clients. Fee-for-service is the term for Medicaid paid services that are not provided through a health plan. Doulas must submit fee-for-service claims through CHAMPS. 

Step 6:  Enroll/Credential with a Medicaid Health Plan 

Most Medicaid beneficiaries are enrolled in a Medicaid Health Plan. After enrolling in CHAMPS, doulas wishing to provide services to Medicaid Health Plan members must become credentialed with each Medicaid Health Plan in the doula’s geographic service area.

Credentialing with Medicaid Health Plans is an extensive process and varies by plan; please note the process could take several months.

Doulas must submit claims for services provided to Medicaid Health Plan members to the Medicaid Health Plan. The Medicaid Health Plan then reimburses the doula for services provided to MHP members. To identify which Medicaid Health Plan is associated with a specific county, refer to Medicaid Health Plans: List of Medicaid Health Plans Contact and Service Listing.

Doula Special Projects Contact List - Contact information for the Medicaid Health Plans can be found here. Please reach out with any questions. If you have already reached out to the general Medicaid Health Plan support and require additional ‘doula specific’ assistance, please reach out to the Special Projects doula contact from the list.

Additional Information: 

Doula providers are also subject to all relevant policy provisions outlined in the MDHHS Medicaid Provider Manual, including the General Information for Providers Chapter. The Medicaid Provider Manual contains participation, coverage, and reimbursement policies related to Medicaid, Healthy Michigan Plan, and other healthcare delivery programs administered by the Department of Health and Human Services (MDHHS).  

 

Visit our Resources for Doulas page for billing information, guides, webinars & more.

Contact us at MDHHS-MIDoula@michigan.gov