Maternal child services
The New Baby, New LifeSM program is a comprehensive proactive care management and care coordination program for all expectant mothers and their newborns. It offers:
- Individualized, one-on-one care management support for women at the highest risk.
- Care coordination for moms who may need a little extra support.
- Educational materials and information on community resources.
- Incentives to keep up with prenatal and postpartum checkups and well-child visits after the baby is born.
This program helps identify pregnant women as early in their pregnancies as possible. Once pregnant members are identified, we act quickly to assess obstetrical risk and ensure appropriate levels of care management services to mitigate risk.
If you would like more information about the OB Care Management program or have a patient who would benefit from care management, contact Provider Services.
Anthem Blue Cross and Blue Shield (Anthem) requires notification of pregnancy after the first prenatal visit and notification of delivery following birth. You may choose to complete the notification of pregnancy and delivery in the online Interactive Care Reviewer (ICR) or fax the forms to Anthem.
We also encourage providers to complete the Maternity form in Availity :
- Perform an Eligibility and Benefits (E&B) request on an Anthem member.
- Choose one of the following benefit service types: maternity, obstetrical, gynecological, or obstetrical/gynecological.
- Before the benefit results screen, you will be asked if the member is pregnant. Choose Yes, if applicable. If you indicate “Yes” you will be asked what the estimated due date is and may fill that date out if you know it or have an estimate. You may leave this field blank if the due date is unknown.
- After submitting your answer, the E&B will display. If the member was identified as pregnant, a Maternity form will now be available. You may access the form by navigating to the Applications tab and selecting the Maternity link.
Substance use disorders in pregnancy and neonatal abstinence syndrome
Substance use disorders (SUDs) are on the rise and are of particular concern in women of childbearing age who are or may become pregnant. OB providers have a unique opportunity to help break the pattern of opioid misuse, thus, avoiding health consequences for both mother and child. The important steps in this practice are to identify treat, and/or refer to treatment women who are using/abusing unhealthy substances. Anthem is here to support providers, pregnant members and their little ones on the way.
If you would like more information about the OB Care Management program or have a patient who would benefit from care management, contact Provider Services.
My Advocate® program
As part of New Baby, New Life, members are offered the My Advocate program. My Advocate provides pregnant and postpartum women proactive, culturally appropriate outreach and education through interactive Voice Response (IVR). Eligible members receive regular calls with tailored content from a voice personality (Mary Beth) or they may choose to access My Advocate via a smartphone application or website. This program does not replace the high-touch care management approach for high-risk pregnant women; however, it does serve as a supplementary tool to extend our health education reach.
Each automated My Advocate communication gives the member specific health care education in a warm, easy-to-understand fashion. Eligible members receive regular messages with tailored content from Mary Beth in English or Spanish. The topics include:
- Obstetric high-risk screening.
- Maternal and child health:
- Prenatal care
- Postpartum care
- Well-baby care
For more information on My Advocate, visit https://www.myadvocatehelps.com .
Neonatal Intensive Care Unit (NICU) Care Management Program
For parents with infants admitted to the NICU, we offer the NICU Care Management program. This program provides education and support designed to help members cope with the day-to-day stress of having a baby in the NICU, encourages them to stay involved in the care of their babies and helps them prepare themselves and their homes for discharge. Parents are provided with educational resources that outline successful strategies they may use to collaborate with the care team.
The stress of having an infant in the NICU can potentially result in Post-Traumatic Stress Disorder (PTSD) symptoms among parents and loved ones. In an effort to reduce the impact of PTSD among members, we assist by:
- Guiding parent(s) into hospital-based support programs, if available, as well as to target support services and referrals to providers
- Screening parent(s) for PTSD approximately one month after the date of birth
- Referring parent(s) to behavioral health program resources, if indicated
- Reconnecting with families with a one-month follow-up call to assess if the parent(s) received benefit from initial contact and PTSD awareness
If you would like more information about the NICU Care Management program or have a patient who would benefit, please contact Provider Services.
Forms
To view and access forms related to pregnancy and maternal child services, please visit the Forms page.
Related resources
- Coding Spotlight - Pregnancy
- Maternal cardiovascular health
- Postpartum Interventions for Maternal Morbidity and Mortality
- Pregnancy notification process using the Benefit Look-Up Tool
- Safe prevention of primary cesarean delivery
- Postpartum Visit Schedule
- New Baby, New LifeSM Booklet
- Prenatal ultrasound diagnosis (Dx) code update
- Adding Modifier 52 to the routine anatomic evaluation billing code
- Availity Provider Notice and FAQ
- Correction: cervical length measurement by transvaginal ultrasound
- Cervical Cancer Screening Age
- Cervical Cancer Screening Frequency
- Facility reimbursement for early elective deliveries
- Cervical length screening guidelines
- Postpartum mood disorders flier
Page Last Updated: 03/30/2023