Maternal child services

Taking Care of Baby and Me®

Taking Care of Baby and Me® is a comprehensive, proactive case management and care coordination program for all expectant mothers and their newborns. It offers:

• Individualized, one-on-one case 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 and case management services to mitigate risk.

If you would like more information about the OB Case Management program or have a patient who would benefit from case management, call Provider Services at 1-833-707-0868.

Notification of pregnancy

We require 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 or fax the forms to Wellpoint at 1-800-964-3627. We also encourage providers to complete the Maternity Module in Availity.

To complete the maternity module in Availity:

1. Perform an Eligibility and Benefits request on a Wellpoint member.
2. Choose one of the following benefit service types: Maternity, Obstetrical, Gynecological, Obstetrical/Gynecological.
3. Before the benefit results screen, you will be asked if the member is pregnant. Choose “Yes,” if applicable, and note the estimated due date. You can leave this blank if the due date is unknown.

After submitting your answer, you’ll be taken to the member’s benefits page. A Maternity Module will now be available for this member in the Payer Spaces section of Availity.

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 first step in this practice is to identify, treat and/or refer to treatment women who are using/abusing unhealthy substances. Wellpoint is here to support providers, pregnant members and their little ones on the way.

If you would like more information about the OB Case Management program or have a patient who would benefit from case management, call Provider Services at 1-833-707-0868.

Neonatal intensive care unit (NICU) case management program

The NICU Case Management program is committed to ensuring all our high-risk infants have a well-defined plan for quality and cost-effective NICU care and, when ready, a safe and successful transition to the home environment. We provide a seamless, integrated approach, including early identification of members for NICU Case Management and continued oversight through case closure.

Our NICU Case Management program encourages parental involvement in their infant’s care while hospitalized in the NICU. We focus on parents of infants expected to be in the hospital greater than two weeks who were born at 34 or fewer weeks’ gestation, born weighing 2,000 grams or less, born with major congenital anomalies, require ventilator care, or require major surgery. We provide NICU parents with the You and Your Baby NICU booklet, which includes materials and support designed to help cope with the day-to-day stress of having a baby in the NICU, teaches them about staying involved in the care of their babies, and helps prepare themselves and their homes for discharge.

The stress of having a critically ill 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 our members, we assist by:

• Guiding parent(s) into hospital-based support programs, if available, as well as to targeted 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
• Re-connecting 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 Case Management program or have a patient who would benefit from case management, call Provider Services at 1-833-707-0868.

Forms

To view and access forms related to pregnancy and maternal child services, please visit the Forms page.

 Pregnancy Notification Form

 MCS Notification of Delivery