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

Anthem Blue Cross and Blue Shield (Anthem) offers pregnant women several services and benefits through the New Baby, New LifeSM program. Anthem provides education, support, resources and incentives to members throughout the prenatal and postpartum period. Our goal is to ensure all pregnant members are identified early in their pregnancies so that they can take full advantage of these services.

 

We are working with Availity, the vendor supporting the Benefit Look-Up Tool you may currently use in your OB office, to get information about newly identified pregnant women. This new process, including the HEDIS® Maternity Attestation form, helps connect members to additional benefits as soon as possible using a few simple steps.

 

How it works

 

When an Anthem member of childbearing age visits the OB office, the office associate is prompted to ask 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 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 Anthem in improving birth outcomes with early intervention.

 

We are working hard to support providers throughout Wisconsin in receiving necessary training for this new workflow. If you have specific questions regarding the new Availity maternity attestation process, please feel free to reach out to Provider Services at 1-855-558-1443.

 

HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).