Pregnancy and Maternal Child Services
New Baby, New LifeSM
The New Baby, New LifeSM program 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 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:
- Phone: 1-855-661-2028
- Hours: Monday to Friday from 8 a.m. to 6 p.m. ET (Interactive Voice Response (IVR) System available 24 hours a day, 7 days a week)
Notification of pregnancy and delivery
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 via Availity or fax the forms to Anthem Blue Cross and Blue Shield Medicaid (Anthem) at 1-800-964-3627.
We also encourage providers to complete the Maternity Module in Availity:
- Perform an eligibility and benefits request on an Anthem member.
- Choose one of the following benefit service types: maternity, obstetrical, gynecological, obstetrical/gynecological.
- 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, 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.
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.
Fax notification forms to:
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, call Provider Services at 1-855-661-2028, Monday to Friday from 8 a.m. to 6 p.m. (ET).
My Advocate® program
As part of our New Baby, New LifeSM program, members are offered the My Advocate program:
- This program provides pregnant and postpartum women 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 case 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 healthcare 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 www.myadvocatehelps.com.
Neonatal Intensive Care Unit (NICU) 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.
Our case managers are here to help you. If you would like more information about the NICU care management program or have a patient who would benefit, please call Provider Services at 1-855-661-2028, Monday to Friday from 8 a.m. to 6 p.m. (ET).
- 2023 Prenatal Ultrasound Diagnostic Code List
- Coding spotlight — Pregnancy A provider’s guide to diagnosis coding for pregnancy
- Preventing Preterm Birth
- Postpartum Mood Disorder Flier
- Postpartum Visit Schedule
- New pregnancy notification process using the Availity Portal Benefit Look-Up Tool
- 2021 Prenatal ultrasound diagnosis code
- New Baby, New Life Provider Booklet
- Get a car seat or portable crib for going to your prenatal checkups
- Availity — Provider FAQ
- Pregnancy notification - Availity Look-Up Tool
- Reminder: Inpatient newborn stays may require authorization
- Healthy Rewards Program
- Recommended Immunizations for Children from Birth Through 6 Years Old
- Recommended Immunizations for Children 7–18 Years Old
- What is a midwife?
- What is a doula?
- Postpartum Interventions for Maternal Morbidity and Mortality
- Maternal Cardiovascular Health Flier
- Safe Prevention on Primary Cesarean Delivery
Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield Medicaid.