We are committed to the health of both mom and baby. Once a member is identified as pregnant, the goal is to assess any obstetrical risk to ensure the members receive the suitable levels of care and case management.
Programs Offered
Screening, Brief Intervention and Referral to Treatment (SBIRT)
You can use the SBIRT Universal Screening Tool to identify pregnant women who need help with behavioral and problematic issues and refer them to treatment.
CenteringPregnancy
Approved practices under contract with the Centering® Healthcare Institute (CHI) are eligible for program participation. CenteringPregnancy is a program of CHI, an independent company that provides wellness education information on behalf of BlueChoice HealthPlan.
CenteringPregnancy is specifically applicable to obstetricians and gynecological practices that are approved or under contract with CHI. You can use the CenteringPregnancy form to apply for participation in the program. You must have Centering Healthcare Institute membership and also be in the process of achieving Site Approval status.
CenteringPregnancy Billing and Reimbursement:
99078
- Include the modifier TH
- File with evaluation and management codes for the same date of service
- File with specific pregnancy-related diagnosis code
- Pays separately from global maternity
- Reimbursed at $30 per member, per session up to ten visits
0502F
- Retention incentive indicating continued participation
- File with procedure code 99078 on the fifth visit
- File with specific pregnancy-related diagnosis code
- Payable once per benefit period
- Reimbursed at $175 oner, per member
Maternity Program
Maternity Program is a proactive case management program for all expectant mothers and their newborns. It uses extensive methods to identify pregnant women as early in their pregnancy as possible through review of state enrollment files, claims data, hospital census reports, Pregnancy Notification Report forms, and provider and member self-referrals. 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.
View more of what the Maternity Program has to offer in the provider manual.