Table of Contents

1. Introduction – Turn payroll into a predictable beat for your doula practice.
2. Submitting Visits – Log each visit fast to stay on-cycle for payment.
3. Visit Clarification – Answer Loula’s follow-ups within 48 hours to avoid delays.
4. The Pay Cycle Beat – Semi-monthly payouts with a steady two-cycle delay.
5. Example Timeline – See how a September visit flows to an October payday.
6. Loula Pro Tips – Simple habits to keep cash flow smooth and stress-free.
7. Why the Cycle Matters – Loula buffers insurance delays for reliable deposits.
8. 10 FAQs – Quick answers on deadlines, corrections, and payout timing.

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Insurance chatter can feel about as exciting as watching paint dry—but when it determines how (and if!) you get paid, it suddenly gets interesting. Let’s break down the key differences between Medi-Cal and commercial insurance in a way that keeps things fun and useful for your doula practice.

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Medi-Cal: Your Reliable Doula BFF

Since January 1, 2023, Medi-Cal has officially covered doula services across California. Think prenatal visits, birth support, postpartum care, and even miscarriage or abortion support—basically, if it’s part of the birthing journey, Medi-Cal’s got it.

But here’s the twist: Medi-Cal is the payer of last resort.

That means when your client has both Medi-Cal and a commercial plan (like Anthem, UHC, or Blue Shield), the commercial plan is always primary. Medi-Cal only steps in after the commercial plan has paid—or if you can’t bill the commercial plan because you don’t have a contract, you may be out of luck.

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Double Trouble (or Double Coverage?): Clients Rocking Both Plans

If a client carries commercial insurance + Medi-Cal:

• Commercial is primary.
• Medi-Cal is secondary.
• No contract with the commercial plan? You can’t bill, even if Medi-Cal is standing by.

Bottom line: Medi-Cal always plays second fiddle.

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Straight Medi-Cal vs. MCPs: Who Gets the Final Rose?

Here’s where doulas sometimes trip up:

• Straight Medi-Cal is a rare unicorn. Most clients are auto-assigned to a Managed Care Plan (MCP) like LA Care, Health Net, or Molina.
• When verifying insurance, always request photos of the MCP card (front and back)—not just the basic Medi-Cal card.
• That MCP card tells you which payer actually processes the claim and saves you endless back-and-forth later.

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Why This Matters for Your Bottom Line

Getting paid quickly is more than a convenience—it keeps your business healthy. While California law requires health plans to pay “clean claims” within 30 calendar days, that’s only if nothing goes wrong. If a claim is denied or contested, reimbursement can stretch to 30–90 days while you re-submit and appeal.

Medi-Cal’s “payer of last resort” status can create a cash-flow bottleneck. If the commercial insurer delays or rejects a claim, Medi-Cal won’t step in until that process finishes. For doulas counting on steady income, those extra weeks can mean stress and late bills.

Knowing which plan to bill first, collecting MCP card details, and tracking submission deadlines help you avoid this bottleneck. Quick verification and accurate billing keep your invoices moving so you can focus on supporting families—not chasing payments.

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TL;DR for Busy Doulas

• Medi-Cal covers doula services statewide.
• If your client has commercial + Medi-Cal, commercial pays first.
• Always check for an MCP card to avoid billing delays.

Insurance may never be as thrilling as catching a baby’s first cry, but a little know-how keeps your cash flow steady and your clients fully supported.

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10 Frequently Asked Questions (FAQs)

When did Medi-Cal start covering doula services in California?

As of January 1, 2023, Medi-Cal covers doula services statewide—including prenatal visits, birth support, postpartum care, and even miscarriage or abortion support.

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If my client has both commercial insurance and Medi-Cal, who pays first?

The commercial plan is always primary. Medi-Cal is the payer of last resort and only steps in after the commercial plan has paid.

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What happens if I don’t have a contract with the client’s commercial insurer?

Unfortunately, you can’t bill that commercial plan—and Medi-Cal won’t automatically cover the gap. Without a commercial contract, you may not get paid.

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What’s the difference between “Straight Medi-Cal” and a Managed Care Plan (MCP)?

“Straight Medi-Cal” is rare. Most clients are assigned to an MCP like LA Care, Health Net, or Molina. The MCP processes the doula claim.

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How can I make sure I’m billing the right payer for a Medi-Cal client?

Always ask for photos of the MCP card (front and back)—not just the basic Medi-Cal card. That card shows you exactly which plan handles the claim.

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Why is Medi-Cal called the “payer of last resort”?

Because Medi-Cal only pays after all other available insurance options—like a client’s commercial plan—have been billed first.

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What’s the quick takeaway for busy doulas?

Medi-Cal does cover doula services, but when a client has both commercial and Medi-Cal coverage, commercial pays first. Don’t forget to collect the MCP card to avoid billing delays.

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How long does it usually take to receive payment once a claim is filed?

If everything is correct, commercial insurers generally pay within 30 days, but contested claims can stretch to 90 days or more.

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Can I charge the client directly if the commercial insurer denies the claim?

Only if your contract and state regulations allow it. Always confirm your agreement terms before billing a client directly.

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What’s the best way to prevent delayed payments?

Verify insurance before services, confirm MCP details, and submit claims immediately after each visit. Early action helps you stay ahead of potential denials.

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Here’s to making insurance just a little less boring—and a lot more profitable—for every doula out there.