Join our network as a doula

Effective Jan. 1, 2023, Michigan Medicaid will begin reimbursing for doula services provided to our Medicaid members. To be reimbursed for your services, you must first enroll in our provider network. Please note it can take up to 80 calendar days for us to process your enrollment.

Doula enrollment requirements

To enroll in our provider network, a doula must be:

Enrolled in the MDHHS Doula Registry

Doulas providing services to Medicaid beneficiaries will be required to be registered with the MDHHS Doula Registry to enroll as a Medicaid provider. Medicaid’s requirements for registering doulas include:

  • Age: At least 18 years of age
  • Education: High school diploma or equivalent
  • Training: Completed training provided by an MDHHS-approved doula training program or organization. Doulas must provide proof of training to MDHHS upon request.

Enrolled with CHAMPS

Additionally, doulas must have a Type 1 (Individual) National Provider Identifier (NPI) and complete an online application in the Community Health Automated Medicaid Processing System (CHAMPS).

As part of the enrollment process, individually enrolled doulas may also associate their enrollment with Medicaid-enrolled organizations with a Type 2 (Group) NPI.

How to join our networks

Follow the steps below to complete your enrollment application. Be sure to follow them carefully and check that each step of your application is complete and accurate before moving on.

Missing or inaccurate information will delay your processing time. Applications missing either the W9, CHAMPS enrollment or registration with the MDHHS Doula Registry may be rejected as incomplete.

Before submitting your enrollment application, make sure you:

  1. Have your W9 saved to your computer
  2. Review our current Medicaid fee schedule (login required). You'll find 2023 rates for doula services posted to the Practitioner/medical clinic fee schedule as soon as they're available from MDHHS.

Submitting your application

  1. Log into prism or create a prism account.
  2. Select Enrollments & Changes from the main menu, then choose New Individual Provider Enrollment. Follow the prompts to complete your enrollment request.
  3. While completing your doula enrollment application, use the information below for these required fields:

    Practice Type = OTHER
    Provider Specialty = Doula
    CAQH ID number = Enter ‘00000000’
    Provider State License Number = Enter ‘00000000’
    License State = Enter ‘MI’

    Note: To be eligible for Medicaid participation, you must be actively enrolled in CHAMPS.
  4. We'll send you a confirmation comment in prism with next steps as well as any requests for additional/missing information.

Check the status of your application

Once you submit your enrollment application, our team will receive an inquiry. You can check the status of your request and view comments from our team any time in prism by clicking on Enrollments & Changes and selecting the Inquiry ID. When your request is completed, you'll receive a comment from our team. Any time our team posts a comment, you'll receive an email notification.

Our process – once we receive your application

  1. Contracting: Every provider must be under contract with us before they can be in our network. Learn more about provider contracts and agreements.
  2. Enrollment: We ensure providers meet our requirements to be approved as in-network. Once this has been completed, we enroll providers in our systems.
  3. Reimbursement: We configure each provider's reimbursement structure based on their contract.

Our review – what we look for

We review your application and supporting documents for completeness and verify your information. This process takes 90 calendar days. Your application is complete when we've received, verified and/or completed the following:

  • Completed application and signed attestation and release, including copies of professional liability insurance (minimum limits of $100,000 / $300,000)
  • Must be at least 18 years of age and possess a high school diploma or equivalent, verified directly in MDHHS Doula Registry application process
  • CHAMPS enrollment verified, Medicaid only
  • MDCH - Medical Services Administration Sanctioned Providers
  • Office of Inspector General Sanctioned Provider Exclusion Database
  • System for Award Management (SAM)

Find your network effective date

Once your request is complete, you'll receive a final comment from us in prism that includes your network effective date. You can begin billing for dates of service on the network effective date. We’ll also return the countersigned copy or your Provider Group Participation Agreement to you for your records.

Claims submitted before the network effective date may result in incorrect payment or denial.

If you haven’t received a confirmation email that the enrollment is complete within 90 calendar days of your submission, please send an email to exceedsprocessingtime@priorityhealth.com describing the delay. Include your Inquiry ID number in your email.