Dogwood Doula’s Guide to: How to Get a Referral for Doula Care with Tricare

 

Dogwood Doula’s Guide to:

How to Get a Referral for Doula Care with Tricare 

If you are a Tricare beneficiary and want to access doula care, follow these simple steps to secure a referral and start your journey toward supported, confident birthing care.

Step 1: Confirm Your Eligibility

• Plan Type: Ensure you are enrolled in Tricare Prime or Tricare Select. Active duty members require a referral regardless of network status.

• Delivery Location: Referrals are only valid for deliveries outside of Military Treatment Facilities (MTFs). MTF births are not covered under the current program. 

*WOMACK AMC is an MTF. Only those planning to give birth off post are eligible for doula services.

• Provider Requirements: You must plan to give birth with a Tricare-authorized provider, such as an OB/GYN, a family practice doctor, or a Certified Nurse Midwife (CNM). Certified Professional Midwives (CPMs) are not authorized.

• Timing: Doula services can begin once you are at least 20 weeks pregnant.

• Doula Choice: If you already have connected with a doula, determine their network status. 

1. In-Network Doulas do not need referrals. You may skip to step 4.

2. Participating Non-Network Doulas need a referral. Continue to step 2. 

 *As of Dec 2024 Phyllis Herbe of DDBS is Participating Non Network. You will need a referral in order to request services. 

Step 2: Request a Referral

If you are a Tricare Prime beneficiary, you will need a referral for doula services. Follow these steps:

1. Speak to Your OB or Midwife:

• Request that they submit a referral for doula care.

• Ensure the referral specifies “Doula Services” in the body to avoid errors.

• The referral can be submitted through the Tricare Self-Service Portal or by faxing the Patient Referral Authorization form to (877) 548-1547 (Tricare East).

• They can also add your specific preferred doula’s information onto the referral request

*In order to request direct referral to Dogwood Doula Birth Services, request that your PCM adds Phyllis Herbe NPI 1730926908 to the referral body

2. Check with Your Primary Care Manager (PCM):

• If your OB cannot create the referral, contact your PCM.

• Let them know about the requirement for doula services under Tricare’s maternity benefits.

• Be prepared to share supporting documents or details about the program if your PCM is unfamiliar with it.

3. Contact Patient Advocacy:

• If you encounter issues with referral creation, reach out to Patient Advocacy on base for assistance.

Step 3: Verify Your Referral

1. Portal Access: Log in to the Tricare Portal to view your referral status under the “Tricare Patient Profile” section.

• You will need your date of birth and either your Benefits Number (located on the back of your military ID) or Sponsor SSN.

2. Check the Details: Ensure the referral is made out to your chosen doula. If it’s not, call Tricare to update the referral with your doula’s name, NPI, and address.

3. Prime Referral Duration: Referrals for Tricare Prime beneficiaries last six months. Request your referral around 20 weeks to cover your birth and postpartum period.

Step 4: Begin Doula Services

Once your referral is approved:

1. Share the authorization details with your doula.

2. Begin scheduling prenatal visits, labor support, and postpartum care according to the coverage guidelines.

3. Your doula will file claims directly with Tricare, so there’s no out-of-pocket cost for covered services.

*To begin the process with Dogwood Doula Birth Services head to linktr.ee/dogwooddoula to fill out an information request form, book a complimentary meet and greet or contact Phyllis Herbe directly.

Additional Notes for Tricare Select Beneficiaries

• Tricare Select clients do not need a referral to access doula care. Simply connect with a Tricare-approved doula and begin services. 

Need Help?

Navigating Tricare can be confusing, but Dogwood Doula Birth Services is here to assist you every step of the way. Contact us for personalized guidance:

Phyllis Herbe- Certified Labor Doula

• Email: dogwood.doula.info@gmail.com

• Phone: 915-630-4948

• NPI: 1730926908

• Linktree: linktr.ee/dogwooddoula

Let’s work together to make your birth experience empowering and supported!