Maternity Care Management Forms

Notification of a pregnancy and a member’s associated risk factors plays a critical role in ensuring that members are aware of and connected to the services and supports available during pregnancy and the postpartum period.

Providers can submit the Maternity Care Management Form through each Managed Care Organization’s provider portal or via fax.

  • Fax numbers for UnitedHealthcare and Wellpoint can be found on the form.
  • BlueCare Tennessee network providers should submit the Maternity Care Management Form online in Availity®.
    • For help using Availity®:
    • Refer to the Maternity Care Management Authorization Form Quick Reference Guide,
    • Call 423-535-5717 and select option 2, or
    • Email eBusiness_Service@bcbst.com.

Submission of the Maternity Care Management Form is supported with an incentive. For more information about the Maternity Care Management Form, please contact the health plans.

Wellpoint

Call Wellpoint Provider Services: 833-731-2154 or complete an email form at Email a Provider Experience associate | Wellpoint Tennessee, Inc..

BlueCare

Contact MaternityReferralRequest@bcbst.com.

United Healthcare Community Group

When in the UHC provider portal, providers can chat with an advocate in real time. The chat function offers support for claims, prior authorizations, eligibility and benefits, credentialing, as well as technical support.

To chat with a live advocate, go to UHCprovider.com and click Sign In at the top-right corner. Then, enter your One Healthcare ID. After signing in to the portal, chat can be accessed on the Contact Us page, 7 a.m. – 7 p.m. CT, Monday-Friday.

Questions can also be submitted via email to tnhealthyfirststeps@uhc.com.

Can’t find what you need? Contact Jona.Bandyopadhyay@tn.gov.