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导乐服务常见问题

助产师提供者- 注册成为助产师

Department of Health Care Services (DHCS)为Medi-Cal的孕妇和产后成员提供管理式医疗和按服务收费 ( FFS ) 的导乐服务。 服务包括产前和产后访视、分娩、流产和堕胎期间的非医疗支持。

1. 如何成为一名导乐?

Doulas may apply for enrollment through the DHCS PAVE – Provider Application and Validation for Enrollment portal. Supporting videos and additional information on how to apply can be found in the “Doula Application Information” webpage.

陪产员还可以参考Medi-Cal 陪产员服务提供者注册清单,以确定在开始申请之前需要哪些文件。

2. 加入 Medi-Cal 成为助产师需要什么资格?

All doulas must be at least 18 years old, possess an adult/infant cardiopulmonary resuscitation (CPR) certification, and have completed basic Health Insurance Portability and Accountability Act (HIPAA) training. In addition, a doula must meet either of the following qualification pathways:

培训途径:

  • 在以下领域完成至少 16 小时的培训:
    • 哺乳支持
    • 分娩教育
    • 妊娠和分娩解剖学基础
    • 非医疗舒适措施、产前支持和分娩支持技术
    • 制定社区资源清单
  • 证明他们至少在三次分娩中提供过助产士的支持

体验途径:

  • 或者以下两种情况:
    • 过去七年内至少有五年以有偿或志愿者身份积极参与助产工作的经验。
    • 证明具备产前、分娩和产后护理技能,需提供三封客户书面推荐信或以下任何人士出具的专业推荐信:医生、持证行为健康提供者、执业护士、助产士、持证助产士、注册导乐或社区组织。信件必须是近七年内写的。其中一封信必须来自有执照的医疗服务提供者、社区组织或注册助产士。

3. DHCS 是否要求助产士持有特定组织颁发的证书?

No. The certificate does not need to be from a specific organization as long as it covers the requirements listed in the Medi-Cal Provider Manual: Doula Services. Additional information regarding enrollment is available at Doula Application Information webpage.

4. 有经验的助产士是否需要重新认证?如果需要,认证费用是多少?

DHCS does not have a schedule for recertification. If recertification is required in the future, it would be the responsibility of the doula to cover any costs associated with meeting the doula minimum qualifications and training/experience pathway requirements outlined in the Provider Manual.

5. 我如何注册成为 Medi-Cal 医疗服务提供者?

Doulas can enroll through DHCS’ Provider Application and Validation for Enrollment (PAVE) portal: PAVE page. Additional resources on how to enroll in PAVE can be found on the Doula Application Information webpage and Doula – Training and Medi-Cal Providers webpage.

Doulas will also need to contract separately with each individual Medi-Cal managed care plan (MCP) operating within their service area to provide covered services to Medi-Cal members who receive Medi-Cal through the managed care delivery system. Please see the Medi-Cal Managed Care Plan Contact List for names and contact information for each individual MCP who can assist doulas with contracting with the MCP. Please see the MCP enrollment section for more detailed information.

6. 要以导乐身份注册 Medi-Cal,我还需要满足哪些其他要求?

Individuals who enroll in Medi-Cal may also need to meet applicable local (city, county, etc.) or state requirements to operate a business in California. This is particularly important for doula group enrollment. Please see the Medi-Cal Doula Provider Enrollment Checklist to identify what documents you may need to submit as part of your application in the PAVE system.

这些要求是对Medi-Cal 提供者手册:Doula 服务中所述的 DHCS 要求的补充。

7. 我需要获取 NPI 号码吗?

Yes. Doulas will need to register for a National Provider Identifier (NPI) to enroll with DHCS. An NPI is a numeric identifier assigned to a health care provider by the Centers for Medicare & Medicaid Services (CMS). Doulas can apply for an NPI online or by mail through the CMS NPI Application/Update Form page.

8. 获得 NPI 号码通常需要多长时间?

提交完整电子申请的供应商可以在不到 10 个工作日的时间内收到 NPI。 纸质申请审核大约需要 20 个工作日。 应用程序错误可能会延迟该进程。

9. 我需要社会安全号码(SSN)才能注册成为导乐吗?

联邦和州法律要求个人提交其 SSN 才能注册成为 Medi-Cal 提供商。DHCS 只能批准已在入学申请中提交 SSN 的助产士的申请。  

10. 导乐是否需要自己购买保险,还是DHCS会为导乐提供保险? 

DHCS 不为任何服务提供者(包括导乐)提供任何类型的保险。作为 Medi-Cal 服务提供商注册要求的一部分,个人导乐无需购买任何保险即可注册成为 Medi-Cal FFS 服务提供商。但是,助产士团体在注册成为 Medi-Cal FFS 提供商时可能还有其他要求,这些要求将在申请过程中予以说明。此外,各个 MCP 可能有不同的保险要求,例如个人助产士的职业责任保险或助产士团体的工伤赔偿保险,并且助产士必须遵循这些合同和资格认证流程才能为 MCP 成员提供服务。

11. 社区助产士团体、组织和机构可以注册成为助产士团体吗?

是的,如果他们符合申请成为助产士团体的标准。当注册成为团体服务提供商时,团体本身提交一份申请,而每个服务提供商则单独提交一份申请。请访问助产士申请信息页面。

12. 在 PAVE 申请处理期间,陪产员可以为 Medi-Cal 会员提供的服务获得报销吗?

一旦助产士的申请获得批准,她们就可以向加州医疗保健服务部 (DHCS) 收取为 Medi-Cal FFS 会员提供的服务费用,追溯至她们提交并获得批准的申请之日。

希望为 MCP 成员提供服务的导乐必须与 MCP 签订合同或意向书/协议 (LOI/LOA),才能获得为 MCP 成员提供的导乐服务的报销。

13.如果我对我的申请有疑问,我可以联系某人吗?

是的。如果申请人对申请或参加 PAVE 有任何疑问或意见,可以发送电子邮件至 PAVE@dhcs.ca.gov