Baby Partners
Baby Partners provides support for your patients throughout pregnancy and postpartum. Our care coordination team is here to support your patient’s health care needs by helping them manage their care.
Baby Partners Services
- Ongoing telephonic care management by a nurse or social worker
- Home visits by a doula or nurse for high-risk members during pregnancy and postpartum
- Coordination of well mom and baby visits
- 24/7 breastfeeding helpline
- Transportation services to medical and behavioral health appointments
- Referrals to community resources for cribs, car seats and other help
- Prenatal and postpartum home care visits performed by an in-network home care agency. Prior authorization is not required for the following home care visits:*
- High-risk prenatal home care visits
- Postpartum well visits for mother and baby
- Nutritionist home care visits during the prenatal period
The removal of prior authorization for the above home care visits is effective for dates of service on or after June 1, 2016. Please be aware that claims for services for these codes will be denied outside of the specified timeframes detailed in the chart below. Please consult the chart below for suggested ICD-10 codes for correct claims submissions of postpartum home care visits.
|
Visit |
Focus of Visit |
Procedure Code |
Diagnosis Code |
| First visit between 1 to 21 days post-delivery, preferably within the first 7 days | Mother; use mother’s member ID | 99501 |
Z39.2, routine postpartum follow-up |
| Second visit before 84 days post-delivery | Mother; use mother’s member ID | 99501 |
Z39.2, routine postpartum follow-up |
| Visit for evaluation of baby only | Baby; use baby’s permanent or temporary member ID | 99502 |
Z00.111 if baby is under 28 days old; Z00.129 if baby is over 28 days old and normal findings; Z00.121 if baby is over 28 days old and abnormal findings. |
Note: Prior authorization is required for all medically necessary home care services. To request services, please fax a completed Home Care Authorization form to 215-967-4491.
*One well-baby visit is covered without prior authorization. If further visits are medically indicated, follow the usual procedure code for obtaining prior authorization.
Home Visiting Program
HPP encourages in-network providers to refer pregnant members and new parents to an evidence-based home visiting program.
All pregnant HPP members, and parents/guardians of children younger than 18 months, are encouraged to participate in one of these programs. There is no cost to the member.
These programs begin during the pregnancy, or just after the birth, and continue for at least 18 months of the infant’s life. Agency staff visit the family and provide educational resources, resource referrals and ongoing support; visit frequency is dependent on the family’s preference. Here are some of the nationally recognized home visiting programs that are available throughout Pennsylvania:
- Parents as Teachers (www.paparentsasteachers.org, 717-763-1661)
- Nurse-Family Partnership (www.nursefamilypartnership.org, 844-637-6667)
- Early Head Start (www.dhs.pa.gov/Services/Children/Pages/Head-Start.aspx)
- Healthy Families America (www.healthyfamiliesamerica.org.
These programs all are proven to improve outcomes for new families by educating parents about child development and improving their parenting skills.
How to Make a Referral to These Programs
All these programs accept referrals through their websites and by phone. Providers can make the referral on the member’s behalf; members may self-refer, as well. You can make the referral by sending an email with the member’s information and your contact information to HomeVisitingReferral@HPPlans.com; HPP’s care coordinator will assist in connecting the family with a program.
HPP’s Baby Partners coordinators educate their members about these programs and help members enroll. HPP also outreaches to members and encourages them to sign up for a home visit program. For more information, contact the Baby Partners team at 1-866-500-4571.
ONAF Reimbursement Program
Please visit our Quality Resources webpage for the current ONAF reimbursement program.