Maternal child services

Taking Care of Baby and Me^SM

Taking Care of Baby and Me^SM is a proactive care management program for all expectant members 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 who can assist with services and support.

Program offerings

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 program, a comprehensive program which offers:

• Individualized, one on one complex care management support for members with the highest risk
• Care coordination for those members who 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)

Digital perinatal app

As part of the Taking Care of Baby and Me^SM 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 allows us to assess their pregnancy risk.

After the risk assessment has been completed, the app delivers gestational 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 Wellpoint to 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 with members. Members may access information about the products that are available by visiting the Wellpoint member website.

For more information about the Taking Care of Baby and Me^SM program or the digital app, please contact Provider Services.

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 Wellpoint 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.

Steps for completing the Maternity application

1. Perform an Eligibility and Benefits (E&B) request on the desired member.
2. Choose one of the following benefit service types:
   1. Maternity
   2. Obstetrical
   3. Gynecological
   4. Obstetrical/gynecological
3. If the appropriate conditions apply for payer, user, member and service type, the maternity question screen will display. Conditions include:
   1. Member is female
   2. Member is 45 years of age or under
   3. Member 15 years of age or over
4. If member is not pregnant, select ‘No’ and then submit your selection to continue to the E&B response screen.
5. If member is pregnant, select ‘Yes’ and submit your selection. You will be prompted to enter additional date information if available. Including:
   1. Estimated Due Date
   2. First Prenatal Appointment Date
6. When ‘Yes’ is selected, maternity data entered is saved for this member.
7. After final submission, the E&B response screen will display.