Proof artifact
A public, source-backed map from HCA birth doula billing requirements to DoulaPaid safeguards, routes, and validation evidence.
This artifact proves whether the product has a verifiable safeguard for each public requirement we have encoded.
Total checks
9
Implemented
8
Partial
0
Manual review
1
| Requirement | DoulaPaid safeguard | Evidence | Status |
|---|---|---|---|
Provider setup must be complete before claim packet review. Washington HCA Birth Doula Services Billing Guide, effective April 1, 2026 | Provider setup checklist tracks certification, NPI, ProviderOne enrollment, W-9, and documentation template readiness. | /provider-setup and /states/wa/provider-setup | Implemented |
Client eligibility and Apple Health identity must be verified before submission. Washington HCA Birth Doula Services Billing Guide, effective April 1, 2026 | Client intake marks records missing info until Apple Health ID and eligibility date are present. | /clients/new and missing-fields warning component | Implemented |
Prenatal intake is represented as CPT 59899 with modifier U1 and the published flat payment amount. Washington HCA Birth Doula Services Fee Schedule, effective January 1, 2025 | WA StateRuleset encodes 59899, U1, and $750 flat pricing. | src/lib/state-rulesets.ts and /states/wa/rate-calculator | Implemented |
Additional prenatal and postpartum visits use 15-minute T1032 units at the published unit amount. Washington HCA Birth Doula Services Fee Schedule, effective January 1, 2025 | Service creation uses centralized 15-minute unit calculation and StateRuleset pricing. | src/lib/billing-rules.ts, src/lib/actions.ts, and claim packet matrix tests | Implemented |
Labor and delivery support is represented as HCPCS T1033 and the published flat payment amount. Washington HCA Birth Doula Services Fee Schedule, effective January 1, 2025 | WA StateRuleset encodes T1033 and $750 flat pricing. | src/lib/state-rulesets.ts and /states/wa/rate-calculator | Implemented |
In-person prerequisites and telemedicine limitations must be surfaced before packet export. Washington HCA Birth Doula Services Billing Guide, effective April 1, 2026 | Readiness checks warn on telemedicine prenatal intake and labor support. | claimReadiness unit tests and /states/wa/documentation-checklist | Implemented |
Documentation must support billed service lines, service date, duration, and care activity. Washington HCA Birth Doula Services Billing Guide, effective April 1, 2026 | Visit documentation, packet notes, missing-field warnings, and documentation checklist are included in the workflow. | /services/new, /claims/[id]/packet, and /states/wa/documentation-checklist | Implemented |
Claims should be reviewed for timely filing risk before submission. Washington HCA Birth Doula Services Billing Guide, effective April 1, 2026 | Denial decoder includes timely filing risk and next action guidance. | /states/wa/denials/timely-filing-risk | Implemented |
Manual packet review must remain distinct from automated payer submission. DoulaPaid MVP scope and HCA source-backed packet workflow | Claim packet export produces structured review material; it does not submit EDI or guarantee payment. | /claims/[id]/packet and public billing guide FAQ | Manual review |
Provider setup must be complete before claim packet review.
ImplementedClient eligibility and Apple Health identity must be verified before submission.
ImplementedPrenatal intake is represented as CPT 59899 with modifier U1 and the published flat payment amount.
ImplementedAdditional prenatal and postpartum visits use 15-minute T1032 units at the published unit amount.
ImplementedLabor and delivery support is represented as HCPCS T1033 and the published flat payment amount.
ImplementedIn-person prerequisites and telemedicine limitations must be surfaced before packet export.
ImplementedDocumentation must support billed service lines, service date, duration, and care activity.
ImplementedClaims should be reviewed for timely filing risk before submission.
ImplementedManual packet review must remain distinct from automated payer submission.
Manual reviewThe conformance matrix is not a substitute for HCA review. It is a way to keep product behavior tied to public requirements.