Doulas who are members of DONA have just received this news:
DONA International is pleased to announce that a new code for doulas in the United
States has been approved and defined by the National Uniform Claim Committee. This
code will come into effect on October 1, 2009 for services rendered after that date.
Pat Burrell, a birth doula and registered nurse from South Carolina, was successful
in lobbying for the assignment of the code, which will allow doulas to be assigned
provider numbers to submit claims to both Medicaid and third-party payers for their
“While this does not guarantee third-party reimbursement, it is an enormous step
forward in our mission to ensure a doula for every woman who wants one” says Debbie
Young, President of DONA International. “Individual doulas will have to apply for
a provider number and comply with other requirements that have yet to be determined.
Regardless, we are excited to announce Ms. Burrell’s success with this initiative,
which will benefit thousands of women and families for years to come. This is an
exciting day in childbirth in the United States.”
For further information, please contact Jessica Atkins, DONA Third Party Reimbursement
Chair, at 3PRChair@DONA.org [mailto:3PRChair@DONA.org] or Stefanie Antunes, Director
of Public Relations, at PublicRelations@DONA.org [mailto: PublicRelations@DONA.org].
**End of DONA mailout**
When I read “enormous step forward”, “excited to announce” and “exciting day in childbirth”, I had a sinking feeling that we are being sold a bill of goods. Why does this obtaining of a number equate to a breakthrough and why do the DONA members need to be hyped? What do you think?
Here’s what it says on the National Uniform Claim Committee site:
Under the Nursing Service Related Providers Type, the Doula Classification was added:
Doulas work in a variety of settings and have been trained to provide physical, emotional, and informational support to a mother before, during, and just after birth and/or provide emotional and practical support to a mother during the postpartum period.
It’s going to be interesting to see if any DONA doulas point out the obvious to their leadership.
1. Getting an assigned provider number is a good way to give the government access to every move you make. That might be okay if they were paying you, but they are not and they do their best to avoid paying so it’s highly unlikely they ever will.
2. Although DONA’s stated intention is to provide a doula for every woman, the truth is more likely that they’d like doulas to get paid without the messiness of asking for money or turning down clients who don’t value the service enough to pay. It seems that some women are so allergic to the concept of asking for money that they will sell themselves to the devil to avoid saying “Can I get a cheque from you today, please?”
3. Probably, if Medicaid or other insurers were paying doulas, the doulas would get an “attitude” and stop giving their all at births. In fact, they might even start requiring clients to hire yet another woman to do the back rubbing and staying up all night while doulas do the more professional doula work like filling out papers for Medicaid. Then, those back rubber women will form an organization and want the government/insurance companies to pay them, too. And so on, and so on.Here’s a link to a wordier document on the insurance committee at DONA. http://www.dona.org/PDF/3PRDONAStatement.pdf It’s copyrighted in 2000 so I don’t know if it’s current.
All I can say to the DONA doulas is “Sometimes the devil you know is better than the devil you don’t know.” Take a long, hard look at these documents and ask yourself where the inauthenticity is. Don’t, for a minute, think that a government agency or insurance giant is going to give you a handout without exacting a heavy price.
Previous related post: Licensing, registering and certifying midwives–at what cost?