New pregnancy notification process using Availity’s benefit look-up tool
As you know, Anthem Blue Cross and Blue Shield (Anthem) and our affiliate HealthKeepers, Inc. offer pregnant women several services and benefits through the Future Moms program. It is our goal to try to ensure all pregnant members are identified early in their pregnancy so they can take full advantage of the education, support, resources and incentives Anthem 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 obstetrics/gynecology (OB/GYN) office – to send us information about newly identified pregnant women. With a few simple steps, this new reporting process – including the HEDIS® Maternity Attestation form – helps connect patients with additional benefits as soon as possible.
How the process works for women enrolled in Anthem and HealthKeepers, Inc.’s health plans
When female members of childbearing age visit an OB/GYN’s office, the office associate is prompted to answer the question “Is the member pregnant?” during the eligibility and benefits inquiry process. If the response is “yes,” the system asks about the due date, and a HEDIS Maternity Attestation form is generated for the OB/GYN office to complete. On this electronic form, physicians 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 process generates timely information that aids members, providers, Anthem and HealthKeepers, Inc. in improving birth outcomes with early intervention.
We are working hard to support physicians and their staffs throughout Virginia in receiving the necessary training for the new Availity maternity attestation process. If you have specific questions about the new process, please feel free to reach out to our customer service area toll free using the telephone number on the back of members’ Anthem or HealthKeepers, Inc. ID cards.
For easy reference, we've included some common questions and responses in the attached frequently asked questions (FAQs) document under "Articles Attachments." Please refer to the FAQs as needed.
August 2018 Anthem Provider Newsletter -- Virginia