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 and 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, call Provider Services at 833-405-9086, Monday to Friday, 8 a.m. to 6 p.m. Central time (CT).
Notification of pregnancy and delivery to Healthy Blue is required at the first prenatal visit and following birth. You may choose to complete the notification of pregnancy and delivery in the online Interactive Care Reviewer or fax it to 800-964-3627.
Call:
833-405-9086
Fax:
800-964-3627
You should also complete the Availity* Maternity Module:
- Perform an eligibility and benefits request on a Healthy Blue member and choose one of the following benefit service types: maternity, obstetrical, gynecological, or obstetrical/gynecological.
- Before you see the benefit results screen, you will be asked if the member is pregnant and given a yes or no option. If you indicate yes, you will be asked the estimated due date and can fill that date in or leave it blank if you do not have an estimate.
After you submit your answer, you will be taken to the benefits page like normal. In the background, a Maternity Module will have been generated for this patient in the Maternity application in the Payer Spaces for Healthy Blue.
Substance Use Disorders in Pregnancy and Neonatal Abstinence Syndrome
Substance use disorders 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. Healthy Blue 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, call Provider Services at 833-405-9086, Monday to Friday, 8 a.m. to 6 p.m. Central time (CT).
Call Provider Services at:
833-405-9086
My Advocate® Program
This program provides pregnant and postpartum women with proactive, culturally appropriate outreach and education through interactive voice response, smartphone application, or website. Eligible members receive regular calls with tailored content from a voice personality (Mary Beth), or they may choose to access the program 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 in English or Spanish. The topics include:
- Obstetric high-risk screening
- Maternal and child health, including:
- Prenatal care
- Postpartum care
- Well-baby care
For more information on My Advocate, visit www.myadvocatehelps.com .
NICU Care Management
For parents with infants admitted to the neonatal intensive care unit (NICU), we offer the NICU Care Management program. This program provides education and support designed to help parents cope with the day-to-day stress of having a baby in the NICU, encourages parent/caregiver involvement, and helps them to prepare themselves and their homes for discharge. Parents/caregivers are provided with education and resources that outline successful strategies they may use to collaborate with the baby’s NICU care team while inpatient and manage their baby’s health after discharge.
Once discharged, NICU care managers continue to provide education and support to foster improved outcomes, prevent unnecessary hospital readmissions, and promote efficient community resource consumption as needed.
The stress of having an infant in the NICU may result in post-traumatic stress disorder (PTSD) symptoms for parents and loved ones. To reduce the impact of PTSD among our members, we assist by:
- Guiding parent(s) into hospital-based support programs, if available.
- Screening parent(s) for PTSD approximately one month after their baby’s date of birth.
- Referring parent(s) to behavioral health program resources, if indicated.
- Reconnecting with a one-month follow-up call to assess if the parent(s) received benefit from initial contact and PTSD awareness.
If you are caring for a NICU member or are working with a parent/caregiver who would benefit from NICU Care Management services, please call 833-388-1406. Parents/caregivers can also call our 24-hour Nurse Helpline at 866-231-0847 (TTY 711), available 24 hours a day, seven days a week.
Related Information
- Improved outcomes for pregnant women and foster youth
- Supporting Pregnant Women Receiving Missouri Medicaid
- Postpartum Mood Disorder Flier
- Coding Spotlight — A provider’s guide to diagnose and code for pregnancy
- New Baby, New Life Provider Booklet
- Availity Portal Pregnancy Notification Process Maternity Application Form: Frovider FAQ
- Primary Care Toolkit for Neonatal Abstinence Syndrome/Neonatal Opioid Withdrawal Syndrome Prevention and Posthospital Follow-Up
- Cervical Cancer Screening for Women Under 21
- Routine Cervical Cancer Screening
- Transvaginal Ultrasound Reduction
- Pregnancy Notification Form
- Newborn Notification of Delivery Form
- Postpartum Visit Schedule
- Safe Prevention of Primary Cesarean Delivery
- Prenatal Ultrasound Coverage and Coding
- Timelines to Prenatal Care Flyer
- Pregnancy Notification Using the Benefit Lookup Tool
- Maternal Child Services Clinical Guidelines
- Postpartum Interventions for Maternal Morbidity and Mortality
- Maternal Cardiovascular Health Flier
- 2023 Prenatal Ultrasound Diagnostic Code List
- Healthy Blue and the Doula Network- Doula Informational Webinar
Provider Tools & Resources
- Log in to Availity
- Launch Provider Learning Hub Now
- Learn about Availity
- Precertification Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Eligibility Overview
- Provider Manual and Guides
- Provider Search Tool
- Forms
- Training Academy
- Electronic Data Interchange (EDI)
- Quality of Care Incident Form