Pregnancy and maternal child services

New Baby, New LifeSM

The New Baby, New LifeSM program is a proactive case management program for all expectant mothers and their newborns. Once pregnant members are identified, we act quickly to assess obstetrical risk and ensure appropriate levels of care management services to mitigate risk.

Experienced care managers work with members and providers to establish a care plan for our highest-risk pregnant members. They may also collaborate with community partners to facilitate connecting members to local and national agencies that can assist with services and support.

When it comes to pregnancy, we are committed to healthy outcomes for our members and their babies. That is why we encourage all of our pregnant and postpartum members to take part in our New Baby, New Life program, a comprehensive program that offers:

  • Individualized, one-on-one case/care management support for members with the highest risk
  • Care coordination for those members who may need a little extra support
  • Digital perinatal educational tools
  • Information on community resources
  • Incentives to encourage members to keep up with checkups
  • Proactive care management support for parents of infants who are admitted to the neonatal intensive care unit (NICU)

As part of the New Baby, New Life program, perinatal members have access to a digital perinatal offering. This digital offering is available by smartphone app and provides pregnant and postpartum members with timely, proactive, and culturally appropriate education. Once members are identified as being pregnant, they will receive an invitation to access this program by downloading the app. After the app is installed and the member registers, they are asked to complete a pregnancy screener. The answers provided in the screener allow us to assess their pregnancy risk.

After the risk assessment is completed, the app delivers gestation-age-appropriate education directly to the member. This digital offering does not replace the high-touch, individual care management approach for our highest-risk pregnant members; however, it does serve as a supplemental tool to extend our health education outreach. The goal of the expanded outreach is to ensure maternity education is available to all perinatal members and help Anthem identify members who experience a change in risk acuity throughout the perinatal period.

We encourage healthcare providers to share information about this program and the digital perinatal app offered to members. Members may access information about the products that are available by visiting the Anthem member website.

For more information about the New Baby, New Life program or the digital app, please call Provider Services at 855-558-1443 TTY: 711.

Notification of pregnancy and delivery

We request notification of pregnancy at the first prenatal visit and notification of delivery following birth. You may choose to complete the notification of pregnancy and delivery in Availity Essentials or by faxing the completed forms to Anthem at 800-964-3627.

We also ask that providers complete the Maternity Application in Availity Essentials during the initial Eligibility and Benefits (E&B) request performed on a pregnant member. The information obtained during this process supports our effort to identify pregnancies as early as possible so that we may notify eligible members of various perinatal resources, including the care management program. The steps to complete the Maternity Application are as follows:

  • Perform an E&B request on the desired member
  • Choose one of the following benefit service types:
    • Maternity
    • Obstetrical
    • Gynecological
    • Obstetrical/Gynecological
  • If the appropriate conditions apply for payer, user, member, and service type, the maternity question screen will display. Conditions include:
    • Member is female
    • Member is 45 years of age or under
    • Member 15 years of age or over
  • If the member is not pregnant, select No and submit to continue to the E&B response screen
  • If the member is pregnant, select Yes and submit. You will be prompted to enter additional dates if known:
    • Estimated Due Date
    • First Prenatal Appointment Date
  • When Yes is selected, the maternity data entered is saved for this member
  • After submitting your answer, the E&B response screen will display

Neonatal Intensive Care Unit (NICU) Care Management Program

If a baby is born premature or with a serious health condition, they may be admitted to the NICU. We believe the more parents know, the better they will be able to care for their infant. To support them, we have a NICU Care Management program.

We extend our support by helping parents to prepare themselves and their homes for when their baby is released from the hospital. After baby is home, our care managers continue to provide education and assistance in improving the baby’s health, preventing unnecessary hospital readmissions, and guiding parents to community resources if needed.

The NICU can be a stressful place, presenting unique challenges and concerns that parents may never have imagined. The anxiety and stress related to having a baby in the NICU can potentially lead to symptoms of post-traumatic stress disorder (PTSD) in parents and caregivers. To reduce the impact of PTSD among our members, we assist by:

  • Helping parents engage with hospital-based support programs.
  • Facilitating parent screenings for potential PTSD.
  • Connecting parents with behavioral health program resources and community support as needed.
  • Actively asking for parent feedback on the provided resources and how an increased awareness of PTSD has helped.

For more information about the NICU Care Management Program, please call Provider Services at 855-558-1443 TTY: 711.

Forms

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

Related information

Provider tools & resources

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