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.
Provider 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_marketing@bcbst.com. Submission of the Maternity Care Management Form is supported with an incentive.
To learn more, review the Maternity Care Management Form information from the December 2021 Maternal Health Updates Webinar.
- Maternity Care Management Form [Slides]
Can’t find what you need? Contact Jona.Bandyopadhyay@tn.gov.