How to get contracted with Partnership HealthPlan as a doula

1. 1

   Enroll as a Medi-Cal provider in PAVE

   Partnership’s policy MPCR15 lists Medi-Cal enrollment among the initial requirements: doulas must enroll as a Medi-Cal provider, through DHCS’s PAVE portal. It also restates DHCS’s basics: at least 18, adult and infant CPR certification, and HIPAA training.

   New to enrollment? See how to become a Medi-Cal doula.

2. 2

   Email Partnership’s doula team

   Partnership doesn’t post a doula application online. DHCS’s plan contact list gives DoulaServices@partnershiphp.org for doula contracting and onboarding: email there to ask for the credentialing application and contract.

   Under MPCR15, every doula who has an independent relationship with Partnership is credentialed before serving members. If you’ll work under a doula group that contracts with Partnership, ask how the group’s doulas are credentialed.

3. 3

   Gather the credentialing documents

   MPCR15 lists what every doula applicant sends:

   • A completed and signed application.
   • A valid NPI.
   • A valid, current business license.
   • Proof of professional liability coverage in the amount set in Partnership’s provider contract. Ask for the required amount before you buy a policy.
   • Your agreement to hand over records of services you provided if Partnership audits them.
   • A signed Doula Attestation confirming you qualify through the training pathway (at least 16 hours covering lactation support, childbirth education, anatomy of pregnancy and childbirth, nonmedical comfort and labor support, and a community resource list, shown with a certificate or syllabus, plus support at three or more births) or the experience pathway (five years of doula work in the last seven and three letters, at least one from a licensed provider, a community-based organization or an enrolled doula).

   Partnership’s benefit policy adds one more commitment: doulas attest that they’ll support care in line with ACOG guidelines, including recommended provider visits and vaccinations for the parent and newborn.

4. 4

   Expect background and sanction checks

   Before approving you, Partnership confirms you’re free of sanctions, limitations, a history of liability claims, or criminal history. It queries the OIG exclusions list, DHCS’s Medi-Cal Suspended and Ineligible Provider List, CMS exclusions, SAM, and the National Practitioner Data Bank (which also covers the past five years of malpractice settlements). Anyone on a sanction list can’t take part in Medi-Cal.

5. 5

   Plan for re-credentialing every 36 months

   Credentialing isn’t one-and-done. Every 36 months (counted to the month from the last decision) you’ll send a new signed application, proof of current adult and infant CPR, proof of liability coverage, your NPI and a valid business license. Keep evidence of your three hours of continuing education in maternal, perinatal or infant care every three years; DHCS can ask for it.

   If you leave Partnership for administrative reasons, it can reinstate you within 30 days without full credentialing; after that you start over.

6. 6

   Follow Partnership’s rules for visits and documentation

   Partnership’s benefit policy (MPNP9006, January 2026) adds rules beyond the statewide basics:

   • Eligibility: confirm with Partnership that the member’s Medi-Cal is valid for the month of service.
   • Collaborating provider: record the name and practice of a licensed practitioner involved in the member’s care (for example an MD, DO, NP, PA or LCSW). Your initial visit record must name a collaborating or recommending perinatal provider.
   • Every visit: document your NPI, the date, time and duration, and the services provided. Partnership expects you to share documentation with the member’s perinatal providers.
   • Extra postpartum visits: the standing recommendation covers the usual package. Up to nine more postpartum visits need a Treatment Authorization Request (TAR) with a licensed practitioner’s recommendation, reviewed for medical necessity.
   • Incidental help during a home visit, like folding laundry, is fine as part of the visit, but you can’t bill the member for it.
7. 7

   Bill with DHCS’s diagnosis pairings

   Partnership reimburses doulas under their network contract and Medi-Cal’s doula guidelines, and its coding attachment is blunt: claims are denied if they have no diagnosis code, or a diagnosis that isn’t the one DHCS pairs with that procedure code. On a CMS-1500, put the diagnosis in box 21A without the decimal point (Z322, not Z32.2).

   • Electronic claims: Partnership takes 837 claims from enrolled trading partners (clearinghouses list its payer ID as 10164) and has an online services portal; claim questions go to the Claims Department at (800) 863-4155, option 4.
   • Paper claims with attachments: Partnership HealthPlan of California, Attn: Medi-Cal Claims Dept., P.O. Box 1368, Suisun City, CA 94585-1368. Partnership doesn’t accept faxed claims.

   The code-by-code diagnosis pairings are in our Medi-Cal doula billing cheat sheet.

   Partnership’s policy says it will arrange out-of-network doula access when no in-network doula is available. That’s the plan’s promise to members, not a substitute for a contract: get credentialed before you bill.

This guide summarizes Partnership HealthPlan of California’s published material for convenience and is not billing or legal advice. Plans change their processes and contacts; follow your contract and confirm with Partnership before you apply or bill.