[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-306358-105":3,"detail-sidebar-cat-1-en-105":81,"doc-detail-306358-en":126},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","doula-quick-reference-guide-contracting-and-covered-services","Doula Quick Reference Guide - Contracting and Covered Services","","Doula Quick Reference Guide outlines community-based doula services available through Humana Healthy Horizons in Virginia and explains how providers can participate. It details contracting requirements, including NPI, Virginia DMAS certification for registered Medicaid providers, and enrollment in the DMAS PRSS portal. The guide covers referral rules, the DMAS Doula Care Form submission process, visit authorization limits, covered services, member eligibility verification, and key claim coding requirements for billing claims correctly.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/letters/","Letters",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/doula-quick-reference-guide-contracting-and-covered-services/306358/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/doula-quick-reference-guide-contracting-and-covered-services/306358.png","ImageObject",442,249,{"name":42,"@type":43},"Cipher","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-12","2026-09-19",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",12,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What are the required steps for doulas to contract with Humana Healthy Horizons in Virginia?","Question",{"text":63,"@type":64},"Doulas need an NPI, DMAS certification as a registered Medicaid provider with completion of the federal and state screening process, and enrollment in the DMAS Provider Services Solution (PRSS) portal, selecting Humana Healthy Horizons in Virginia.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How must doulas submit the DMAS Doula Care Form and what does it enable?",{"text":68,"@type":64},"The DMAS Doula Care Form is required to provide doula services to members. Providers download it from the Virginia Medicaid Community Doula Program website and submit the completed form to Humana Healthy Horizons by email (VAMCDMaternity@humana.com) or fax (877-245-1704).",{"name":70,"@type":61,"acceptedAnswer":71},"What claims and billing details are required when submitting doula claims?",{"text":72,"@type":64},"Claims must include HD modifier on every claim line, diagnosis code Z32.2, required taxonomy Doula (374J00000X), and billing the NPI on the claim. Providers must accept Humana Healthy Horizons reimbursement as payment in full.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},306358,1790722734,{"code":4,"msg":82,"data":83},"success",[84,89,93,98,103,108,113,117,122],{"id":85,"doc_module":22,"doc_module_name":25,"category_name":86,"show_sort_weight":87,"slug":88},11,"Presentations",90,"presentations",{"id":55,"doc_module":22,"doc_module_name":25,"category_name":90,"show_sort_weight":91,"slug":92},"Resumes",80,"resumes",{"id":94,"doc_module":22,"doc_module_name":25,"category_name":95,"show_sort_weight":96,"slug":97},14,"Invoices",70,"invoices",{"id":99,"doc_module":22,"doc_module_name":25,"category_name":100,"show_sort_weight":101,"slug":102},15,"Posters",60,"posters",{"id":104,"doc_module":22,"doc_module_name":25,"category_name":105,"show_sort_weight":106,"slug":107},16,"Social Media",50,"social-media",{"id":109,"doc_module":22,"doc_module_name":25,"category_name":110,"show_sort_weight":111,"slug":112},17,"Forms",40,"forms",{"id":114,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":115,"slug":116},18,30,"letters",{"id":118,"doc_module":22,"doc_module_name":25,"category_name":119,"show_sort_weight":120,"slug":121},21,"Paper Templates",5,"papers-templates",{"id":123,"doc_module":22,"doc_module_name":25,"category_name":124,"show_sort_weight":4,"slug":125},158,"General","general-158",{"code":4,"msg":82,"data":127},{"doc_id":79,"user_id":128,"nickname":42,"user_avatar":129,"doc_module":22,"category_id":114,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":33,"language":135,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":12,"update_tm":139,"read_time":26},687208528416,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Doula Quick Reference Guide  \nHumana Healthy Horizons® in Virginia provides community-based doula services asa covered service to address the drivers of poor maternal and child health outcomes. Community-based doulas or “doulas” are individuals based in the community who offera broad set of nonclinical, pregnancy-related services centered on continuous support throughout pregnancy and in the postpartum period.  \nFor more information on how to become a state-certified community doula, please visit  \n[https://dmas.virginia.gov/for-members/benefits-and-services/maternal-and-child-health/](https://dmas.virginia.gov/for-members/benefits-and-services/maternal-and-child-health/)[ ](https://dmas.virginia.gov/for-members/benefits-and-services/maternal-and-child-health/)[community-doula-program](community-doula-program.)[.](community-doula-program.)  \nContracting with Humana Healthy Horizons  \nThe following is required for doulas to contract with Humana Healthy Horizons:  \n• National Provider Identifier (NPI)  \n• Certification by the Virginia Department of Medical Assistance Services (DMAS) as a registered Medicaid provider and completion of the federal and state screening process  \n− For more information visit [https://dmas.virginia.gov/for-providers/maternal-and-child-health/](https://dmas.virginia.gov/for-providers/maternal-and-child-health/)[ ](https://dmas.virginia.gov/for-providers/maternal-and-child-health/)community-doula-program.  \n• Enrollment in the DMAS Provider Services Solution (PRSS) portal, available at [https://dmas.virginia](https://dmas.virginia). gov/for-providers/medicaid-enterprise-system  \n− You will be asked which managed care network you would like to join, so be sure to select Humana Healthy Horizons in Virginia.  \nTo join our network, [please use our online form](please use our online form Provider.Humana.com/join-humana-network)[ Provider.Humana.com/join-humana-network](please use our online form Provider.Humana.com/join-humana-network).  \nReferrals, DMAS Doula Care Form and authorization  \n• Referrals: Doulas services must be referred by physicians, certified professional midwives, certified nurse midwives, licensed midwives, nurse practitioners, physician assistants and other licensed mental health professionals (e.g., licensed clinical psychologist, licensed professional counselor, licensed clinical social worker, licensed substance abuse treatment practitioner, licensed marriage and family therapist, and certified psychiatric clinical nurse specialist).  \nHumana Healthy Horizons in Virginia is a Medicaid product of Humana Wisconsin Health Organization Insurance Corporation.  \n746102VA0625 VAHMHEHEN_0624  \n• The DMAS Doula Care Form is required to provide doula services to Humana Healthy Horizons members. Providers can download the form on the Virginia Medicaid Community Doula Program website. The form is located toward the bottom of the web page and is available in both English and Spanish. Find the form at [https://dmas.virginia.gov/for-members/benefits-and-services/](https://dmas.virginia.gov/for-members/benefits-and-services/)[ ](https://dmas.virginia.gov/for-members/benefits-and-services/)[maternal-and-child-health/community-doula-program](maternal-and-child-health/community-doula-program. Submit the completed form to Humana)[. Submit the completed form to Humana](maternal-and-child-health/community-doula-program. Submit the completed form to Humana)[ ](maternal-and-child-health/community-doula-program. Submit the completed form to Humana)Healthy Horizons by email at [VAMCDMaternity@humana.com](VAMCDMaternity@humana.com) or fax to 877-245-1704.  \n• Authorization: Authorization is not required for the allowed ten prenatal/postpartum visits and one attendance at delivery. Doula visits beyond the visit limit of ten prenatal/postpartum visits and one attendance at delivery may be authorized if medically necessary.  \n− The visit limit applies to a doula-member pair. If a member receives care from more than","cbCaifuXIesi3b2w","https://ap.wps.com/l/cbCaifuXIesi3b2w","pdf",106645,"English","# Contracting with Humana Healthy Horizons\n## Required provider contracting steps\n# Referrals, DMAS Doula Care Form, and authorization\n## Referrals\n## Doula Care Form and submission\n## Authorization rules\n# Covered services\n# Member eligibility verification\n# Claims and billing requirements","[{\"question\":\"What are the required steps for doulas to contract with Humana Healthy Horizons in Virginia?\",\"answer\":\"Doulas need an NPI, DMAS certification as a registered Medicaid provider with completion of the federal and state screening process, and enrollment in the DMAS Provider Services Solution (PRSS) portal, selecting Humana Healthy Horizons in Virginia.\"},{\"question\":\"How must doulas submit the DMAS Doula Care Form and what does it enable?\",\"answer\":\"The DMAS Doula Care Form is required to provide doula services to members. Providers download it from the Virginia Medicaid Community Doula Program website and submit the completed form to Humana Healthy Horizons by email (VAMCDMaternity@humana.com) or fax (877-245-1704).\"},{\"question\":\"What claims and billing details are required when submitting doula claims?\",\"answer\":\"Claims must include HD modifier on every claim line, diagnosis code Z32.2, required taxonomy Doula (374J00000X), and billing the NPI on the claim. Providers must accept Humana Healthy Horizons reimbursement as payment in full.\"}]","Doula Quick Reference Guide - Contracting and Covered Services | PDF",1789835671]