5 Steps to Applying With Medicaid as a Doula Provider
Ready to start the Medicaid enrollment process but not sure where to begin? Make sure you have first read our blog post What does it mean to Enroll as a Medicaid Doula Provider? and ensure you understand what you are about to do. Great now that you’ve decided you are ready to begin Medicaid doula enrollment here are five clear steps to guide you through the application — from paperwork to approval.
Download and following along with our handy 2 page PDF Quick Start Guide for Medicaid doula and Managed Care Organizations (MCOs) enrollment
Step 1: Check Your State’s Eligibility Requirements
Every state has different requirements for doula providers who want to enroll in Medicaid. Some states require specific certifications (DONA, CAPPA, TOlabor, etc.); others accept a range of training programs. Start by visiting your state Medicaid website and reviewing the doula provider section of the provider manual. Know what’s required before you gather documents so you don’t waste time.
Step 2: Obtain Your NPI Number
Your National Provider Identifier (NPI) is a unique 10-digit identification number issued by the Centers for Medicare & Medicaid Services (CMS). You cannot enroll in Medicaid without one. Apply for your NPI at NPPES (the National Plan & Provider Enumeration System) — it’s free and typically issued quickly.
Keep your NPI number written somewhere accessible. You will use it constantly — on every application, every claim, every form.
Step 3: Gather Your Documents
For individual enrollment, you’ll typically need:
· Completed state Medicaid provider enrollment application
· Copy of your doula training certification
· Copy of your government-issued ID
· Signed W-9 form
· Voided check (for direct deposit setup)
· NPI number
For business/entity enrollment, add:
· Business legal name, address, phone, and email
· Tax ID / Employer Identification Number (EIN)
· Business bank account voided check
Important: Documents requiring a signature may not accept digital signatures. Print, sign by hand, and scan before submitting. Download a free scanning app on your phone to make this easier.
Step 4: Submit Your Fee-for-Service Application and Wait
Submit your completed application to your state Medicaid agency. This phase of enrollment takes approximately 45 days. During this time, do not begin serving Medicaid clients. Wait for written confirmation of your enrollment date before scheduling any Medicaid-covered visits.
Use this waiting period to organize your documentation system, learn how to submit claims, and research which MCOs operate in your service area.
Step 5: Apply to Individual MCOs
Once your Medicaid fee-for-service enrollment is confirmed, you can begin applying to individual Managed Care Organizations. Each MCO has its own provider application, credentialing process, and timeline — plan for approximately 45 days per plan.
Create a physical and digital folder for each MCO with copies of everything you submitted. MCOs routinely request documents you’ve already provided. Having organized records saves significant time.
While you are waiting to enroll with the MCOs read Understanding Medicaid Fee-for-Service vs. Managed Care: What Doulas Need to Know to understand why you should enroll in both.
