New pregnancy notification process using the Availity Portal Benefit Look-Up tool

As you know, Empire BlueCross BlueShield HealthPlus (Empire) offers pregnant women several services and benefits through the New Baby, New LifeSM program. It is our goal to ensure all pregnant members are identified early in their pregnancy so they can take full advantage of the education, support, resources and incentives Empire provides throughout the prenatal and postpartum period.

 

We’ve partnered with Availity, the vendor supporting the Benefit Look-Up tool you may currently use in your OB office, to send us information about newly identified pregnant women. This new process, including the HEDIS® Maternity Attestation form, helps connect patients with additional benefits as soon as possible. The reporting process includes a few simple steps.

 

How it works

When an Empire member of childbearing age visits the OB office, the office associate asks if the member is pregnant during the eligibility and benefits inquiry process. If the member is pregnant, the system asks about the due date, and a HEDIS Maternity Attestation form is generated for the OB office to complete. On this electronic form, providers are asked to provide other important information, including the date of the first prenatal care visit, delivery date and postpartum visit date.

 

This new, user-friendly workflow generates timely information that aids members, providers and Empire in improving birth outcomes with early intervention.

 

We are working hard to support providers throughout New York in receiving necessary training for this new workflow. If you have specific questions regarding the new Availity maternity attestation process, please feel free to call Provider Services at 1-800-450-8753.