CITYWIDE DOULA INITIATIVE

Introductory Resources for Doulas

  • Medicaid Enrollment Guide: This brief guide providers an overview of the full Medicaid Enrollment process, from getting approved as a NY Medicaid provider to completing contracts with Managed Care Organizations, and billing for services. Click here to download.

 

Medicaid Enrollment Resources

In order to provide services to New York State Medicaid members, doulas must first apply to be a Medicaid provider with the state and demonstrate that they have met minimum requirements for program participation. In order to support doulas in navigating this process the NYC REACH team has developed the following resources:

  • Medicaid Enrollment Training: Provides an overview of the NY state application process and program requirements. To access a recording of the training, click here.
  • Medicaid Enrollment Guide: This brief guide providers an overview of the full Medicaid Enrollment process, from getting approved as a NY Medicaid provider to completing contracts with Managed Care Organizations, and billing for services. Click here to download.

 

Managed Care Enrollment Resources

Once you are approved as a NYS Medicaid provider, the next step in the process will be to contract with Managed Care Organizations (MCOs) such as Healthfirst, MetroPlus, etc. This is important because Medicaid providers can only provide services to clients covered by companies that they are contracted with. The below resources provide additional information about the contracting process overall, and how to submit an application to each company:

  • Managed Care Enrollment Training: Provides an overview of the Managed Care enrollment process, requirements, and how to apply for a contract with each company. To access a recording of the training, click here.

 

Billing Resources

The below resources have been developed to provide an introduction to Medicaid provider billing requirements, and how to submit claims for payment on various platforms.

  • ePACES Billing Training: ePACES is a free web-based application operated by the electronic Medicaid New York (eMedNY) system, through which providers can do things like check Medicaid eligibility, create and submit Medicaid fee-for-service claims, and get claim status updates. This training provides an overview of how to navigate the platform and utilize its key features. To access a recording of the training, click here.
  • ePACEs Billing Guide: For doulas wanting more in-depth information about how to set-up their ePACEs account and manage their billing on the platform, we have developed an ePACEs billing guide to accompany the training. To download the guide, click here.
  • Managed Care Billing Training: Doulas contracted with Managed Care organizations must submit claims for services provided to their members directly to the company through an approved method. All the MCOs allow providers to use either electronic claim submission platforms (such as Availity) to submit and manage claims online, or paper claim forms which can be mailed in for processing. To access a recording of our Managed Care billing training, click here.
    • To download the training slides, click here.
    • Availity Set-up Tutorial: As a supplement to this training, we have also recorded a brief training on how to set-up your Availity account as an individual provider. Click here to access the recording.

 

2025 NYC REACH Support for CDI Doulas

To support doula enrollment with NY State Medicaid and Medicaid Managed Care Plans, the NYC REACH team will make the following services available to doulas participating in the Citywide Doula Initiative:

  • Virtual and in-person trainings on:
    • The Medicaid provider enrollment process and relevant forms
    • Contracting requirements and processes set forth by Medicaid Managed Care plans serving CDI clients
    • How to set up online accounts to manage billing (including ePACES, Availity, Trizetto, etc.), and how to submit claims for payment for fee-for-service clients
  • One-on-one support, including:
    • Document review
    • Guidance on how to submit materials
    • Explanation of the doula benefit and provider requirements
    • Support navigating the claim submission processes and billing issues
  • Small group office hour sessions in which doulas can ask questions about the Medicaid provider requirements, how to submit their materials, how to manage billing, and become contracted providers with Managed Care plans
  • Email responses to doulas’ questions about Medicaid enrollment paperwork, requirements, Managed Care contracting, claim denials, and support understanding potential errors that may have occurred with their submission.
  • The NYC REACH team has also developed tailored resources to support doulas in navigating the Medicaid enrollment process, including a Medicaid enrollment guide, and detailed ePACEs billing guide, which have been made available to all CDI doulas via the CDI Google Drive. Additional resources may be developed and made available based on need.