Doula Cov Kev Pab Cuam Tshuam Cov Lus Nug
Doula Cov Chaw Pabcuam - Cov FAQs
Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) them rau cov kev pabcuam doula hauv kev saib xyuas kev tswj hwm thiab cov txheej txheem xa khoom them nqi rau cov tswv cuab Medi-Cal cev xeeb tub thiab tom qab yug menyuam. Cov kev pab cuam suav nrog kev txhawb nqa uas tsis yog kev kho mob rau kev mus ntsib kws kho mob ua ntej yug menyuam thiab tom qab yug menyuam, thiab thaum lub sijhawm yug menyuam, kev rho menyuam, thiab kev rho menyuam.
1. Cov kev pabcuam dab tsi yuav doulas muab rau kev them rov qab?
Doulas tuaj yeem muab ntau hom kev txhawb nqa thaum lub sijhawm cev xeeb tub, suav nrog thaum cev xeeb tub; kev ua haujlwm thiab kev yug me nyuam, nchuav menyuam, thiab rho menyuam; thiab mus txog rau ib xyoos tom qab yug me nyuam. Cov kev pabcuam suav nrog kev taw qhia; kev noj qab haus huv navigation; Cov ntaub ntawv pov thawj kev kawm rau kev yug menyuam, tom qab yug menyuam, yug menyuam, thiab kev saib xyuas menyuam mos / menyuam mos; txhawb nqa lactation; kev loj hlob ntawm txoj kev npaj yug me nyuam; thiab kev sib txuas rau cov peev txheej hauv zej zog. Thov mus saib Medi-Cal Phau Ntawv Qhia: Doula Services kom paub ntau ntxiv.
2. Puas muaj tej yam uas yuav tsum tau ua kom tiav ua ntej ib tug tswv cuab thiaj li tau txais cov kev pabcuam doula?
Doula services are considered a preventive benefit. Federal law requires that all preventive services first be recommended by a physician or other licensed practitioner of the healing arts. To increase access to services, DHCS issued a standing recommendation for doula services by the DHCS Medical Director, Karen Mark, MD, PhD. This fulfills the federal requirement for a recommendation to initiate doula services and Medi-Cal members do not need to separately obtain a recommendation. Doulas should reference this standing order in their records for the Medi-Cal member.
Yog tias ib tug tswv cuab ntawm Medi-Cal tau siv tag nrho yim qhov kev mus ntsib kws kho mob thaum cev xeeb tub thiab xav tau txais kev pabcuam doula ntxiv thaum lub sijhawm tom qab yug menyuam, tus tswv cuab tuaj yeem thov kom tus kws kho mob uas muaj ntawv tso cai ua kom tiav daim ntawv pom zoo rau kev pabcuam Doula ntawm Medi-Cal thiab muab daim ntawv rau tus kws kho mob doula.
3. Leej twg thiaj pom zoo cov kev pab cuam doula?
Since the DHCS Medical Director, Dr. Karen Mark, MD, PhD, has issued a standing recommendation for doula services, Medi-Cal members do not need a separate recommendation from a physician or other licensed provider for the initial set of services as described in the Medi-Cal Provider Manual: Doula Services. However, Medi-Cal members will need a new recommendation to receive up to nine additional postpartum visits. This recommendation must be made by a physician or other licensed practitioner of the healing arts acting within their scope of practice under state law. The recommending provider does not need to be enrolled in Medi-Cal or be a network provider with the member’s managed care plan (MCP).
4. Cov kev pabcuam doula twg tau txais kev tso cai los ntawm kev pom zoo?
Qhov kev pom zoo sawv cev tso cai rau cov tswv cuab tau txais cov kev pabcuam doula hauv qab no:
- Ib zaug pib 90-feeb mus ntsib.
- Txog li yim zaus mus ntsib kws kho mob ntxiv uas yuav muab tau rau hauv kev sib xyaw ua ke ntawm kev mus ntsib kws kho mob ua ntej yug menyuam thiab tom qab yug menyuam, raws li tus neeg yug menyuam thiab doula txiav txim siab.
- Kev them nyiaj yug thaum cev xeeb tub thiab yug menyuam, rho menyuam, thiab nchuav menyuam.
- Txog li ob ncua peb teev tom qab yug me nyuam tom qab qhov kawg ntawm cev xeeb tub.
A second recommendation from a physician or other licensed practitioner of the healing arts acting within their scope of practice under state law is required for Medi-Cal members to receive up to nine additional visits during the postpartum period. See questions #5 and #6 below for more information.
5. Muaj pes tsawg zaus kev mus ntsib tom qab yug menyuam?
Qhov kev pom zoo thib ob - uas tau sau tseg rau hauv cov ntaub ntawv kho mob ntawm tus tswv cuab los ntawm tus kws kho mob uas tau tso cai lossis daim ntawv pom zoo rau Medi-Cal Doula Services uas tau kos npe: daim ntawv mus ntsib tom qab yug me nyuam ntxiv - tso cai rau cov tswv cuab kom tau txais txog cuaj qhov kev mus ntsib ntxiv thaum lub sijhawm tom qab yug me nyuam. Cov lus pom zoo tsis tso cai rau cov kev mus ntsib tom qab yug me nyuam ntxiv no.
6. Puas yog qhov kev pom zoo thib ob rau kev pabcuam tomqab yug menyuam yuav tsum tau sau hnub tomqab cev xeeb tub?
No. If the member has used or is likely to use all eight additional visits while they are pregnant, a licensed provider may recommend additional visits to be provided during the postpartum period.
7. Lub sijhawm tom qab yug menyuam ntev npaum li cas rau cov kev pabcuam doula?
Rau doula kev pab them nqi, lub sij hawm tom qab yug me nyuam muaj txog li ib xyoos tom qab qhov kawg ntawm cev xeeb tub, uas tso cai rau cov tswv cuab ntawm Medi-Cal tau txais kev pab doulas nyob rau lub sijhawm no.
8. Ib tug tswvcuab puas tuaj yeem tau txais kev pabcuam doula nkaus xwb thaum lub sijhawm tomqab yug menyuam?
Yog lawm. Cov kev pabcuam Doula muaj txog li ib xyoos tom qab cev xeeb tub. Yog tias tus tswvcuab tsis muaj doula thaum cev xeeb tub, lawv tuaj yeem siv qhov kev mus ntsib thawj zaug thiab tag nrho yim mus ntsib thaum lub sijhawm tomqab yug menyuam thiab txog li cuaj qhov kev mus ntsib tomqab yug menyuam ntxiv nrog rau tsab ntawv pom zoo thib ob.
9. Puas yog DHCS puas yuav them cov kev pabcuam doula thaum lossis tom qab nchuav menyuam, tseem yug menyuam, lossis rho menyuam?
Yog lawm, cov kev pabcuam doula muaj los txhawb cov tib neeg thaum lub sijhawm thiab tom qab cev xeeb tub uas xaus rau kev nchuav menyuam, tseem yug menyuam, lossis rho menyuam tawm.
10. Puas muaj tej yam uas yuav tsum tau them rov qab rau kev pab txhawb nqa doula thaum lub sijhawm lossis tom qab rho menyuam?
Yog. Txhawm rau kom paub tseeb tias qhov kev kho mob tsim nyog rau cov kev pabcuam yog tias muaj kev tshuaj xyuas ntawm lub xeev lossis tsoomfwv tebchaws thiab ua kev tiv thaiv ntxiv rau cov doulas, kev them rov qab rau kev txhawb nqa doula rau kev rho menyuam tsuas yog muaj thaum tus kws kho mob uas muaj ntawv tso cai (piv txwv li, tus kws kho mob, tus kws saib xyuas neeg mob, tus kws pab yug menyuam, lossis tus kws pab yug menyuam uas muaj ntawv tso cai) tau lees paub qhov cev xeeb tub ua ntej kev rho menyuam. Kev lees paub tuaj yeem yog cov ntaub ntawv pov thawj ntawm kev pabcuam ua ntej yug menyuam los ntawm tus neeg muab kev pabcuam uas muaj ntawv tso cai los ntawm kev thov, cov ntaub ntawv ntsib, lossis cov ntaub ntawv kho mob.
Reimbursement for doula support for abortion is only available when there is documentation by claim, encounter data, or medical record of medication or surgical abortion.
Cov Doulas tsis tas yuav muab cov ntaub ntawv pov thawj thaum xa cov ntawv thov thiab nrhiav kev them rov qab rau kev txhawb nqa rau kev rho menyuam lossis kev rho menyuam lossis rau cov kev pabcuam tom qab yug menyuam tom qab rho menyuam lossis kev rho menyuam, tab sis nws yog ib qho kev coj ua zoo tshaj plaws rau cov doulas kom paub meej nrog tus tswv cuab tias qhov cev xeeb tub tau lees paub los ntawm tus neeg muab kev pabcuam uas muaj ntawv tso cai.
11. Puas muaj kev txwv rau qhov twg doulas tuaj yeem muab kev pabcuam?
Tsis yog. Doulas tuaj yeem muab kev pabcuam hauv zej zog, ntawm tus tswvcuab lub tsev, thiab hauv tsev kho mob, ntawm lwm qhov chaw.
12. Puas yog doulas muab kev pabcuam los ntawm telehealth?
Yog. Doula muaj cai muab txhua yam kev pabcuam los ntawm kev kho mob hauv xov tooj, suav nrog kev hu xov tooj. Cov kev pabcuam uas muab los ntawm kev kho mob hauv xov tooj yuav tsum tau them nqi raws li DHCS txoj cai kho mob hauv xov tooj raws li tau teev tseg hauv ntu Tshuaj: Telehealth ntawm Phau Ntawv Qhia Txog Kev Muab Kev Pabcuam Medi-Cal. Qhov no suav nrog kev them nqi nrog modifier 93 rau lub suab sib dhos xwb lossis modifier 95 rau video sib dhos. Cov kev pabcuam uas muab los ntawm kev xa ntawv, email, sib tham, lossis lwm yam kev pabcuam uas tsis yog kev siv suab thiab duab lossis kev siv suab xwb yuav tsis tau them rov qab. Tsis tas li ntawd xwb, txhua yam kev pabcuam doula uas muab los ntawm telehealth yuav tsum ua raws li tsoomfwv cov cai rau kev ceev ntiag tug, suav nrog Txoj Cai Kev Pov Hwm Kev Noj Qab Haus Huv thiab Kev Lav Ris Haujlwm.
Txoj cai ntawm Medi-Cal hauv kev kho mob hauv xov tooj yuav tsum kom txhua tus neeg muab kev pab, suav nrog cov doulas, uas muab kev pab cuam los ntawm kev kho mob hauv xov tooj yuav tsum muaj peev xwm muab kev pab cuam rau tus doula uas ntsib tus kheej, yog tias tus tswv cuab ntawm Medi-Cal thov.
13. Ib tug tswv cuab puas tuaj yeem tau txais cov kev pabcuam doula los ntawm ntau tshaj ib tug doula?
Yog lawm, ntau tshaj ib doula tuaj yeem muab kev pabcuam thaum tus tswvcuab cev xeeb tub thiab lub sijhawm tomqab yug menyuam. Txawm li cas los xij, tag nrho cov kev mus ntsib uas ib tug tswv cuab tuaj yeem tau txais yog ib qho kev xeeb tub thiab tsis yog ib qho doula. Tsis tas li ntawd, tsuas yog ib qho doula tuaj yeem them nqi rau cov kev pabcuam thaum lub sijhawm ua haujlwm, nchuav menyuam, lossis rho menyuam tawm.
DHCS lees paub tias tej zaum yuav muaj ntau yam laj thawj uas ua rau ib tug tswv cuab Medi-Cal yuav pom ib lossis ntau tus doulas thaum lawv cev xeeb tub, lossis txawm tias tib hnub ntawd. Piv txwv li, ib tug tswv cuab ntawm Medi-Cal yuav ntsib nrog ib lossis ntau tus doulas ua ib feem ntawm cov txheej txheem ntawm kev txheeb xyuas tus doula uas ua tau raws li lawv tus kheej xav tau zoo tshaj plaws. Ib yam li ntawd, ib tug tswv cuab ntawm Medi-Cal yuav tsum tau hloov cov doulas thaum lub sijhawm lawv cev xeeb tub. Vim li no, txoj cai Medi-Cal tsis txwv tsis pub ob tug doulas muab kev mus ntsib kws kho mob ua ntej yug menyuam lossis tom qab yug menyuam thaum lub sijhawm cev xeeb tub ntawm ib tug tswv cuab Medi-Cal lossis txawm tias tib hnub.
14. Cov kws pab yug menyuam tshwj xeeb puas yuav muaj peev xwm muab cov kev pabcuam doula rau lawv qhov kev tshwj xeeb?
DHCS tau tsim ib txoj kev rau npe rau cov doulas, yog li lawv yuav tsum muaj peev xwm muab txhua yam kev pabcuam doula uas teev nyob rau hauv Phau Ntawv Qhia Txog Kev Muab Kev Pabcuam Medi-Cal: Cov Kev Pabcuam Doula - kev saib xyuas ua ntej yug menyuam, kev yug menyuam, thiab kev saib xyuas tom qab yug menyuam. Cov Doulas yuav muaj cov cheeb tsam tshwj xeeb. Cov no tau teev nyob rau hauv Doula Directory.
DHCS tau ua haujlwm nrog ntau tus neeg muaj feem cuam tshuam los tsim cov txiaj ntsig doula uas ntseeg tias kev paub txog kev yug menyuam yog qhov tseem ceeb los muab kev saib xyuas zoo tom qab yug menyuam. Yog li ntawd, DHCS tsis muaj cov phiaj xwm los tsim cov doulas tshwj xeeb.
15. Cov kws pab yug menyuam puas pab tau yug menyuam hauv tsev?
Yog lawm, doula tuaj yeem pab yug menyuam hauv tsev los ntawm tus kws kho mob uas muaj ntawv tso cai. Medi-Cal tsis muaj kev txwv qhov twg doulas yuav muab kev pab.