Commercial - Medical Management Programs |
Maternity Program
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Maternity coverage may vary by product. Refer to Member Services at 1-800-251-7722 for determination of coverage.
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ConnectiCare developed the Birth Expectations maternity program to evaluate a member’s risk factors for preterm delivery,
educate the member on the signs and symptoms of preterm labor (regardless of
risk factors) and provide individualized education materials, home care and case
management follow-up for high-risk obstetrical patients.
Physicians should pre-certify patients with ConnectiCare before
sixteen weeks of gestation. (Please use the Obstetrical Pre-Certification Form.) To precertify 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 enroll your high-risk member, call the Birth Expectations nurse:
(860) 674-2003 or 1-800-390-3522, option 5
To arrange for post-delivery services, as outlined in the chart on the following page, call:
ConnectiCare Baby Line
1-888-935-2229
Note: 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:
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Type of Delivery
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Mandated Benefit — Vaginal: 48 hours Cesarean: 96 hours
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Optional stay — Vaginal: more than 1 day, less than 48 hours
Cesarean: more than 3 days, less than 96 hours
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Optional stay — Vaginal: 1 day Cesarean: 3 days
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Vaginal Delivery
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• skilled nursing visit by a maternal child health nurse
• 1 lactation consultant visit at home up to 2 months postpartum
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• skilled nursing visits by a maternal child health nurse
• 1 lactation consultant visit at home up to 2 months postpartum
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• 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
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Cesarean Delivery
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• 1 lactation consultant visit at home up to 2 months postpartum
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• skilled nursing visits by a maternal child health nurse
• 1 lactation consultant visit at home up to 2 months postpartum
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• 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
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