Doula contracting for Medicaid in Ohio: FAQ

Anthem Blue Cross and Blue Shield Medicaid is now accepting contract requests from providers who perform doula services. Doulas provide physical, educational, and emotional support during pregnancy and childbirth. Services provided by community-based doulas are effective interventions in reducing health equity gaps and improving birth outcomes. Doula service has been associated with fewer birth complications and improved maternal engagement.

All Medicaid providers in Ohio must first be credentialed and enrolled with the Ohio Department of Medicaid (ODM) through the Provider Network Management (PNM) website before contracting with Anthem.

How do I register on the PNM website?

A: Providers who are not already registered and active as a Medicaid provider in Ohio must create an Ohio ID before registering on the PNM website. Please follow the links below for instructions on how to create an Ohio ID and register on the PNM website.

Create Account | OH|ID | Ohio's State Digital Identity Standard

Creating OH ID Account for PNM Quick Reference Guide (PDF)

Once enrolled with ODM via the PNM and showing active, providers may contract with Anthem.

Where can providers request a contract with Anthem?

A: Providers can initiate a contract request with Anthem through the Availity website: 

Essentials Registration & Support | Availity

How long does the contracting process take with Anthem?

A: The contracting process generally takes approximately 30 days to complete from start to finish. For additional contracting resources, please visit the following link: 

Join Our Network (PDF).

When can doulas begin the contracting process with Anthem?

A: Doulas may begin the contracting process and claims will be ready to adjudicate starting on October 3, 2024.

What resources are available to providers regarding the prior authorization and claims submission process?

A: Anthem hosts a general provider orientation bi-monthly. Anthem’s Health Care Networks team will work with individual providers as needed. Please visit our Provider News webpage for more information: Home — Provider News (anthem.com).