Pregnancy and Maternal Child Services
Taking Care of Baby and Me®
Taking Care of Baby and Me® is a comprehensive proactive case management and care coordination program for all expectant mothers and their newborns. All identified pregnant patients are automatically included in the program. 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 help keep up with prenatal exams, postpartum checkups and well-child visits after the baby is born.
This program helps us to identify and support pregnant women as early in their pregnancies as possible. Once pregnant members are identified, we act quickly to assess any obstetrical risk and ensure appropriate levels of care and case management services to mitigate risk.
If you would like more information about Taking Care of Baby and Me® or have a patient who would benefit from OB case management, please call Provider Services:
Provider Services Phone
Hours: Monday to Friday 7 a.m. to 7 p.m.
- 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.
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 practice are to identify treat, and/or refer to treatment women who are using/abusing unhealthy substances. Amerigroup 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 1-800-454-3730, Monday through Friday, 7 a.m. to 7 p.m.
My Advocate® program
As part of the Taking Care of Baby and Me® program, members are offered the My Advocate® program. This program provides pregnant and postpartum women proactive, culturally appropriate outreach and education through interactive voice response. 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 healthcare 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 .
Neonatal Intensive Care Unit (NICU) Care Management Program
The NICU Care Management program is committed to ensuring that all of our high risk infants have a well-defined plan for quality and cost effective NICU care and a safe and successful transition to the home environment. We provide a seamless, integrated approach, including early identification of members for NICU Care Management referral, enrollment, engagement and continued oversight through case closure.
Our program encourages parent/caregiver 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 2000 grams or less, born with major congenital anomalies, require ventilator care, or require major surgery. We provide education and support designed to help them cope with the day-to-day stress of having a baby in the NICU, encourage them to stay involved in the care of their babies and help them 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:
- 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 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, please call us at 1-800-454-3730, Monday through Friday, 7 a.m. to 7 p.m.
To view and access forms related to pregnancy and maternal child services, please visit the Forms page.
- Pregnancy Medicaid versus Planning for Healthy Babies (P4HB) Frequently Asked Questions
- Safe Prevention of Primary Cesarean Delivery
- Twill Pregnancy Solution FAQ
- Postpartum Visit Schedule
- Postpartum Mood Disorder Flier
- Maternal Cardiovascular Health Flier
- Postpartum Interventions for Maternal Morbidity and Mortality
- 2023 Prenatal Ultrasound Diagnostic Code List
- Cervical length measurement by transvaginal ultrasound
- Clinical Guidance for Treating Pregnant and Parenting Women With Opioid Use Disorder and Their Infants
- Coding Spotlight — Pregnancy
- New claim submission process: early elective delivery
- New pregnancy notification process using the Availity Web Portal Benefit Look-up Tool
- Planning for Healthy Babies Quick Reference Card
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
Provider tools & resources
- Log in to Availity
- Launch Provider Learning Hub Now
- Learn about Availity
- Prior Authorization Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Reimbursement Policies
- Provider Manuals, Policies & Guidelines
- Provider Training Academy
- Pharmacy Information
- Georgia Families 360°℠