Maternal Child Services
New Baby, New Life℠
When it comes to our pregnant Healthy Blue members, we are committed to keeping both mom and baby healthy.
That’s why we encourage all of our moms-to-be to take part in our New Baby, New Life program — a comprehensive care management and care coordination program offering:
- Individualized, one-on-one care management support for high-risk women, including referrals to the state’s Care Management for High Risk Pregnancy (CMHRP) program, in accordance with the state’s clinical policy, Pregnancy Medical Home
- Care coordination for moms who may need a little extra support
- Educational materials and information on community resources
- Incentives to keep up with prenatal, postpartum and well-child visits
New Baby, New Life is a proactive care management program for expectant mothers and their newborns. It identifies pregnant women as early in their pregnancy as possible through review of state enrollment files, claims data, lab reports, hospital census reports, provider notification of pregnancy, and delivery notification forms and self-referrals. Once pregnant members are identified, we act quickly to assess obstetrical risk and ensure appropriate levels of care management services to mitigate risk. Our program supports the state’s clinical policies for Pregnancy Medical Home and Obstetrics (OB).
If you would like more information about the OB Care Management program or have a patient who would benefit from care management, please call Provider Services at 844-594-5072.
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) requires notification of pregnancy for Health Blue members 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 (ICR) or fax the forms to Blue Cross NC at 800-964-3627.
We also encourage providers to complete the Maternity form in Availity:
- Perform an eligibility and benefits (E&B) request on the desired member.
- Choose one of the following benefit service types: maternity, obstetrical, gynecological, or obstetrical/gynecological.
- Before the benefit results screen, you will be asked if the member is pregnant. Choose Yes, if applicable. If you indicate Yes, you may provide the estimated due date, if it is known, or leave it blank if the due date is unknown.
- After submitting your answer, the E&B will display. If the member was identified as pregnant, a Maternity form will now be available. You may access the form by navigating to the Applications tab and selecting the Maternity link.
- More information is available in our provider booklet:
The state requires all pregnant members to have a Pregnancy Risk Screening Tool completed at their initial visit. The Pregnancy Risk Screening Tool can be found on the state’s website under Provider Forms.
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 process are to identify, treat, and/or refer to treatment women who are using/abusing unhealthy substances. Healthy Blue is here to support providers, pregnant members, and their little ones on the way.
If you would like more information about the OB Care Management program or have a patient who would benefit from care management, please call Provider Services at 844-594-5072.
My Advocate®
As part of the New Baby, New Life program, Healthy Blue members are offered the My Advocate program. This program provides pregnant 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 My Advocate via a smartphone application or website. This program does not replace the high touch care management approach for high-risk pregnant women. However, it does serve as a supplementary tool to extend our health education outreach.
The goal of the expanded outreach is to identify pregnant women who have become high-risk and facilitate connections between them and our care managers to improve member and baby outcomes. Eligible members receive regular calls with tailored content from Mary Beth. 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 .
NICU support
For parents with infants admitted to the neonatal intensive care unit (NICU), we offer a NICU Care Management program. We also support the state’s Care Management for At-Risk Children (CMARC) program. This program provides education and support designed to help with the day-to-day stress of having a baby in the NICU encourages parent/caregiver involvement, and helps with preparing for baby’s discharge from the hospital and thereafter. Parents/caregivers are provided with education and resources that outline successful strategies they may use to collaborate with the baby’s NICU care team.
The stress of having a critically ill infant in the neonatal intensive care unit 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:
- 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 of 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 Care Management program or have a patient who would benefit from care management, please call Provider Services at 844-594-5072.
Forms
To view and access forms related to pregnancy and maternal child services, please visit the Forms page.