How to get contracted with Gold Coast Health Plan as a doula

1. 1

   Enroll with Medi-Cal

   DHCS’s standing recommendation covers members served by a Medi-Cal enrolled doula, and GCHP’s doula page links DHCS’s enrollment and billing information. Enroll through PAVE first: how to become a Medi-Cal doula.

2. 2

   Answer the certification application’s required areas

   GCHP says it uses the application to run a readiness review: whether you meet DHCS’s requirements and can deliver services the way DHCS and GCHP policy expect. After your organization’s details (name, type, tax ID, NPI, locations and hours, and any other Medi-Cal plan contracts), you answer these areas in 500 words or less each:

   • Qualifications: attestations that you meet the age, CPR and HIPAA requirements and the training standards, plus documents for your training or experience pathway.
   • Training: your initial and ongoing training plans and how you stay current (including the three hours of continuing education every three years).
   • Eligibility, outreach and engagement: your end-to-end referral process, outreach strategy, and how many GCHP members you can serve.
   • Documentation: your record system, how it protects health information, and how you store recommendations.
   • Billing, claims and payments: how you’ll produce claims (an 837 file) or invoices in GCHP’s format, document time and services, and prevent duplicate billing.
   • Data sharing: how you exchange data securely (for example SFTP) and meet HIPAA.
   • Capabilities: how long you’ve provided doula services and how you cover absences.
   • Monitoring and oversight: audits, any fraud, waste or abuse history, and oversight of subcontractors if you use them.

   Don’t include any patient information, define acronyms, and name each file consistently (GCHP’s example: YourOrganizationName_Doula_RequiredArea1A). If a subcontractor provides any part of your doula services, attach the agreement.

3. 3

   Submit it to GCHP’s contracting team

   Have an authorized representative email it to ProviderContracting@goldchp.org with the subject line “Doula Provider Application”. GCHP’s doula page says the contracting team responds within 90 business days; staff may come back to you about any area that doesn’t yet meet the requirements. DHCS lists the same address (Wakesha Rivers) for GCHP doula contracting.

   The 2024 application PDF itself still names an older address (calaimpr@goldchp.org) and a 45-day review. Go by the web page, and use the address it gives.

4. 4

   Bill with an 837 claim or a GCHP invoice

   • Format: a standard electronic claim (837) or an invoice in a GCHP-approved format.
   • Referral on file: you need documentation of the recommendation for doula services to be paid. GCHP publishes its own Doula Services Recommendation Form (English and Spanish), alongside DHCS’s standing recommendation.
   • Codes: Medi-Cal’s doula codes, diagnosis pairings and modifier XP (see our billing cheat sheet). No double billing for services already paid under another benefit.
   • Paper claims: Gold Coast Health Plan, Attn: Claims, P.O. Box 9152, Oxnard, CA 93031-9152. DHCS lists liaision@goldchp.org (spelled that way in DHCS’s list) for doula billing questions.

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