Healthy Blue, an Anthem Company Missouri Providers

Missouri Providers

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.

Who is ProgenyHealth?

ProgenyHealth* is a population health management company specializing in neonatal care coordination for NICU infants. ProgenyHealth’s care coordination team includes neonatologists, pediatricians, nurses, and social workers with a deep understanding of the latest evidence-based protocols needed to manage the care of medically complex newborns.

ProgenyHealth Services

ProgenyHealth’s comprehensive neonatal care management telephonic services team includes nurse care managers, social workers, and care management associates. This team will:

  • Conduct reviews for newborn admissions, continued stays, and discharge planning.
  • Coordinate NICU and special care nursery post-hospitalization newborn care. 
  • Collaborate with the family and hospital staff to ensure safe hospital to home transitions. 
  • Provide ongoing education and care coordination, including hospital readmissions throughout the first year of life.

Forms

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

* ProgenyHealth is an independent company providing neonatal care management services on behalf of Healthy Blue.

Provider Tools & Resources

Interested in becoming a provider in the Healthy Blue Network?

We look forward to working with you to provide quality service for our members.