Taking Care of Baby and Me® is a comprehensive, proactive case management and care coordination program for all expectant mothers and their newborns. It offers:
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 case 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 case management, call Provider Services at 1-833-707-0868.
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 or fax the forms to Wellpoint at 1-800-964-3627. We also encourage providers to complete the Maternity Module in Availity.
To complete the maternity module in Availity:
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.
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 first step in this practice is to identify, treat and/or refer to treatment women who are using/abusing unhealthy substances. Wellpoint 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 case management, call Provider Services at 1-833-707-0868.
As part of Taking Care of Baby and Me, members are also 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 phone 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 communication from My Advocate gives specific health care education in a warm, easy-to-understand fashion. Eligible members receive regular messages with tailored content in English or Spanish. The topics include:
Please visit the My Advocate website for more information.
The NICU Case Management program is committed to ensuring all our high-risk infants have a well-defined plan for quality and cost-effective NICU care and, when ready, a safe and successful transition to the home environment. We provide a seamless, integrated approach, including early identification of members for NICU Case Management and continued oversight through case closure.
Our NICU Case Management program encourages parental involvement in their infant’s care while hospitalized in the NICU. We focus on parents of infants expected to be in the hospital greater than two weeks who were born at 34 or fewer weeks’ gestation, born weighing 2,000 grams or less, born with major congenital anomalies, require ventilator care, or require major surgery. We provide NICU parents with the You and Your Baby NICU booklet, which includes materials and support designed to help cope with the day-to-day stress of having a baby in the NICU, teaches them about staying involved in the care of their babies, and helps prepare themselves and their homes for discharge.
The stress of having a critically ill 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 our members, we assist by:
If you would like more information about the NICU Case Management program or have a patient who would benefit from case management, call Provider Services at 1-833-707-0868.
To view and access forms related to pregnancy and maternal child services, please visit the Forms page.
To view the Prenatal Ultrasound Medical Policy, please visit the Medical Policies and Clinical UM Guidelines page and search for “Maternity Ultrasound in the Outpatient Setting”.