Anthem HealthKeepers Plus / Offered by Healthkeepers, Inc.

Virginia Providers

Maternal Child Services


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/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 Case Management program or have a patient who would benefit from care management, please contact Provider Services.

Notification of pregnancy and delivery

HealthKeepers, Inc. requires notification of pregnancy after the first prenatal visit and notification of delivery following birth. You may fax the notification forms or submit notice online.

Fax notification forms to:


Fax:

1-800-964-3627

Submit notifications online:


Website:

Use the Interactive Care Reviewer (ICR) tool in Availity

 

Maternity Module in Availity

We also encourage providers to complete the Maternity Module in Availity:

  1. Perform an eligibility and benefits request on an Anthem HealthKeepers Plus 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.

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. HealthKeepers, Inc. 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 care management, please contact Provider Services.

My Advocate® program

As part of our 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 (IVR). 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, postpartum, and well-baby care).

Feel free to visit the My Advocate website [link to: https://www.myadvocatehelps.com] for more information. 

Neonatal Intensive Care Unit (NICU) Case Management program

As part of our program, members with infants who are admitted to the NICU are offered the NICU Case 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, encourage them to stay involved in the care of their babies and help 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 Case Management Program or have a patient who would benefit, please contact Provider Services [link to: Contact page].

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