Provider Toolkits and Resources

Using the Provider Toolkits

We have developed these provider toolkits to serve as a central repository for information. In addition to specific toolkits for Behavioral Health and Complex Behavioral Health Services. We have posted information on tools and resources, quick reference guides, and other useful resources.

 
Provider Reference Guides


Maternity and Related Service 

Ouma Health – A partner for Maternity Providers and Molina Members

Molina has partnered with Ouma to help improve maternity care for its members, specifically 
related to timeliness of care. Ouma Health is a clinician-led, maternity telehealth program that provides access to various services. Ouma also has the ability to provide virtual access to maternal-fetal medicine care for patients needing access to that specialty.

Ouma Overview Flyer 

Ouma Fax Referral Form

Doula Process

Doula services went live as a Medicaid benefit on January 1, 2025. The Apple Health (Medicaid) birth doula benefit covers:

One prenatal intake visit
Continuous labor and delivery support
20 hours for additional prenatal and postpartum visits, including one comprehensive postpartum visit

The Apple Health doula benefit is managed directly by the Health Care Authority (HCA), and health plans do not contract with doulas or process any claims associated with doulas services.  For patients who are interested in connecting with a doula, the HCA Find a Provider Tool is the best place to start. 

For more details about coverage, see the birth doula services billing guide.

First Steps services covered through Maternity Support Services (MSS), Infant Case Management (ICM), and Childbirth Education (CBE)

Through the First Steps program, individuals who are covered through Washington Apple Health and are pregnant are eligible for additional preventive and education services through Maternity Support Services (MSS) and Childbirth Education (CBE). Parents of covered infants may be eligible for preventive services through Infant Case Management (ICM). Learn more about First Steps MSS, ICM, and CBE services.  

For more details about coverage, see the https://www.hca.wa.gov/free-or-low-cost-health-care/i-need-medical-dental-or-vision-care/first-steps-enhanced-services

Value Added Benefits

Molina provides various rewards to Members that are eligible to receive financial rewards for engaging in pregnancy care, including completing a post-partum follow-up visit with their pregnancy care provider.
$50 Reward - Pregnancy Notification
$100 Reward - Prenatal Visit
$50 Reward - Postpartum Visit

Lactation Services Breast Pumps - Molina partners with Aeroflow Health, a DME vendor, to support seamless access to breast pumps and pump accessories for eligible members. For more information on Pregnancy Care benefits and resources such as Breast Pumps please visit our website at https://www.molinahealthcare.com/members/wa/mem/Preventive-Care/Pregnancy-Care.aspx

Over the Counter Birth Control

Apple Health (Medicaid) covers over the counter (OTC) birth control without prescriptions or clinic visits, see the OTC Birth Control Flyer. Please share this information with your patients.