Maternal Child Services
The 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 and well-child visits after the baby is born.
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 800-454-3730
We encourage 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 Amerigroup at 800-964-3627.
We also encourage providers to complete the Maternity Module in Availity*:
- Perform an Eligibility and Benefits (E&B) request on an Amerigroup 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 will be asked what the estimated due date is and may fill that date out if you know it or have an estimate. You may leave this field 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.
*Availity, LLC is an independent company providing administrative support services on behalf of Amerigroup.
If a patient would benefit from case management, call
Fax the forms to Amerigroup
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. 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 case management, call Provider Services at 1-800-454-3730.
My Advocate® program
As part of Taking Care of Baby and Me, members are offered the My Advocate program. My Advocate provides pregnant and postpartum 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 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 https://www.myadvocatehelps.com.
Neonatal Intensive Care Unit (NICU) Case Management
The NICU Case Management 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 while inpatient as well as after discharge.
The stress of having an 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 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 Case Management program or have a patient who would benefit, please call Provider Services at 1-800-454-3730.
More information about the NICU program
Call Provider Services:
To view and access forms related to pregnancy and maternal child services, please visit the Forms page.
- Postpartum Mood Disorder Flier
- Provider FAQ — Availity Web Portal pregnancy notification and HEDIS® attestation
- Prenatal Ultrasound diagnosis (Dx) code update
- Cervical Cancer Screening Age
- Cervical Cancer Screening Frequency
- Cervical Length Screening Update
- Racial Disparities Provider Presentation
- Postpartum Visit Schedule
- Coding Spotlight - Pregnancy
- Preventing Preterm Birth Flier
- Safe Prevention of Primary Cesarean Delivery
- New Baby, New Life Provider Booklet
- Blood Lead Testing for High-Risk Children
- OBGYN Ultrasound Update
- Pregnancy notification process using the Benefit Look-Up Tool
- Postpartum Interventions for Maternal Morbidity and Mortality
- Maternal Cardiovascular Health Flier
- 2023 Prenatal Ultrasound Diagnostic Code List
Provider tools & resources
- Log in to Availity
- Launch Provider Learning Hub Now
- Learn about Availity
- Precertification Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Member Eligibility & Pharmacy Overview
- Provider Manuals and Guides
- Training Academy
- Pharmacy Information
- Electronic Data Interchange (EDI)