From Visit Log to Paid Claim: ProviderOne Without Re-Typing (and Superbills for Everyone Else)
Here's a scene every Medicaid-billing doula recognizes. The visit happened weeks ago. It's in your notes, with the date and the time. Now it's billing day, and you're in a payer portal, typing that same visit in again - client, date, units, codes - from your own notes, into a form that will reject the whole claim if one field smells wrong. The work was done once. The documentation of the work gets done two or three times, in two or three systems, and only one of those times pays you.
It doesn't have to work that way, because a claim is not new information. A claim is your visit log, reformatted.
For Washington Apple Health clients, the numbers are fixed and public. The intake pays a flat $750. Labor support pays a flat $750. Visits pay $25 per 15-minute unit against the client's 20 hours - tracked as two sub-pools (1.5 hours reserved for comprehensive postpartum care, 18.5 hours shared), which our hours post walks through. A fully served pregnancy totals $3,500, and not a dollar more: the cap is a cap.
In DoulaPilot, claims are built from the visits you already logged - no re-typing. You select the work; the tool does the unit math and assembles the claim at those rates, once per pregnancy for the flat fees, against the right pools for the visit time. Visits your backup performed are excluded before you can make the mistake (she bills her own time). Anything that would push a pregnancy past its pools or its cap is refused with a reason, not silently trimmed - "this visit would overrun the shared pool" is something you want to hear from your software, not from a denial letter. The claim then moves through a simple, visible life: draft, ready, submitted, paid - or denied, where you can see it and act. And because nobody should have to trust a black box, the tool produces a ProviderOne key-in export - a clean file and printable summary of exactly what to enter - so the claim in the portal and the record in your practice are the same claim.
One roadmap note, stated plainly because doulas have been promised plenty: live electronic submission straight to ProviderOne is on our roadmap, not yet live. Today, DoulaPilot builds the claim and the key-in export; you submit. When electronic submission arrives, it will arrive on top of the same visit log - which is the whole point of building the log first.
And for your private-pay clients, the same log solves a different problem: the superbill. Private insurers generally do not credential doulas directly, so your client - not you - submits for reimbursement, sometimes against an HSA or FSA. What she needs from you is a clean, professional document: dates of service, what was provided, what she paid. A superbill generated from her record gives her exactly that, without you assembling it from invoices and memory at tax time.
One log. Every way of getting paid flows out of it. The visit was the work - it should also be the only paperwork.
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every feature on this page earned its place there first.
Now in private pilot with one doula practice. We'll be in touch when spots open.
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