Maternal child services
Taking Care of Baby and Me®
Taking Care of Baby and Me® 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
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 Obstetrical (OB) Case Management program or have a patient who would benefit from care management, call Provider Services at 1-833-731-2149.
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.
If you have a patient who would benefit from care management, call Provider Services
Fax the forms to Wellpoint
We also encourage providers to complete the Maternity Module in Availity :
- Perform an Eligibility and Benefits request on a Wellpoint 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, 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 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, 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 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 care management, call Provider Services at 1-833-731-2149.
My Advocate® program
As part of our program, members are offered the 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 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 health care 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 .
Provider tools & resources
- Log in to Availity
- Launch Provider Learning Hub
- Learn about Availity
- Prior Authorization lookup tool
- Prior Authorization requirements
- Claims overview
- Member eligibility & pharmacy overview
- Provider manual and guides
- Training Academy
- Pharmacy information
- Electronic Data Interchange (EDI)