Commercial - Medical Management Programs |
Maternity Pre-certification
|
Maternity coverage may vary by product. Refer to Member Services at 1-800-251-7722 for determination of coverage.
|
Physicians should pre-certify patients with ConnectiCare before
sixteen (16) weeks of gestation or as soon as possible after sixteen (16) weeks of gestation. Please use the Maternity Pre-Certification Form to pre-certify for delivery.
ConnectiCare Clinical Review
Fax the pre-certification form to (860) 674-5893 or 1-800-923-2852
or, call Clinical Review at (860) 674 -5860 or 1-800-562-6833.
To arrange for post-delivery services, please call (following delivery or the next business day following delivery):
ConnectiCare Baby Line
1-888-935-2229
Note: As a courtesy to our members, physicians should also notify ConnectiCare of pregnancy loss. This will help prevent
us from inappropriately contacting the member for case management purposes and sending additional
pregnancy-related information.
Post-Discharge Services:
|
Type of Delivery
|
Mandated Benefit — Vaginal: 48 hours Cesarean: 96 hours
|
Optional Early Discharge Program — Vaginal delivery with less than 48 hours length of stay.
Cesarean delivery with less than 96 hours length of stay.
|
Value Added Doula Services — Vaginal inpatient stay after delivery is 1 night or less. Cesarean inpatient stay after delivery is 3 nights or less.
|
|
Vaginal Delivery
|
• 1 skilled nursing visit by a maternal child health nurse
• 1 lactation consultant visit at home up to 2 months postpartum
|
• 2 skilled nursing visits by a maternal child health nurse within two weeks of the delivery
• 1 lactation consultant visit at home up to 2 months postpartum
|
• 2 skilled nursing visits by a maternal child health nurse
• Up to 16 hours of doula care to be used within one month after discharge
• 1 lactation consultant visit at home up to 2 months postpartum
|
|
Cesarean Delivery
|
• 1 lactation consultant visit at home up to 2 months postpartum
|
• 2 skilled nursing visits by a maternal child health nurse within two weeks of the delivery
• 1 lactation consultant visit at home up to 2 months postpartum
|
• 2 skilled nursing visits by a maternal child health nurse
• Up to 16 hours of doula care to be used within one month after discharge
• 1 lactation consultant visit at home up to 2 months post partum
|
