Maternal child services
Wellpoint District of Columbia, Inc. is here to support providers, pregnant enrollees, and their little ones on the way.
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. 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 enrollees 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.
Notification of pregnancy
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 800-964-3627.
We also encourage providers to complete the Maternity Module through Availity Essentials:
- Perform an Eligibility and Benefits request on a Wellpoint enrollee.
- 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 enrollee is pregnant. Choose “Yes,” if applicable, and note the estimated due date. You can leave this blank if the due date is unknown.
After you submit your answer, you will be taken to the benefits page. In the background, a Maternity Application Form will be generated for the enrollee in the maternity application that can be accessed at any time from the Clinical menu dropdown then by selecting the Maternity application.
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 first step in this practice is to identify, treat, and/or refer to treatment women who are using/abusing unhealthy substances.
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 833-707-0868.
Forms
To access forms related to pregnancy and maternal child services, please visit the Forms page.
Related information
Prenatal Ultrasound (PNU) Provider Notice
Comprehensive Code List for PNU Letter
Transvaginal Ultrasound Reduction
Cervical cancer screening coverage
Cervical cancer screening frequency coverage
Notification of Delivery/Newborn
Taking Care of Baby and Me Provider Booklet
Safe Prevention of Primary Cesarean Delivery
Postpartum Interventions for Maternal Morbidity and Mortality
Prenatal Ultrasound Medical Policy
To access the Prenatal Ultrasound Medical Policy, please visit the Medical Policies and Clinical UM Guidelines page and search for “Maternity Ultrasound in the Outpatient Setting.”
Interested in becoming a provider in the Wellpoint District of Columbia network?
We look forward to working with you to provide quality service for our enrollees.