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.
Maternity Home Visiting Program
The Maternity Home Visiting program provides at least two home visits to recently delivered members. The focus of the visits is child development, parenting and referral to any needed community resources. Providers can refer members by emailing Libby Cohen at ecohen@hpplans.com; members can also self refer.
Any parent may request a home visit. Members with the following diagnoses or situations will be referred to the program by HPP’s care coordinators: all first-time parents; parents with substance use, tobacco use, or behavioral health diagnoses; and involvement with child protective services. If ongoing support is needed, the family will be connected with an appropriate provider for continued support. Note: Because of the COVID-10 public health emergency, visits are conducted by phone or video call.
Provider Incentive Program
Submit ONAFs online
Submit ONAFs (Obstetrical Needs Assessment Forms) online at obcare.optum.com. Reference this user guide for more information.
Remember, all three components of the ONAF are an incentive quality measure in the Maternity Quality Care Plus incentive program. Incentive payments are based on the percentage of your member panel for which a completed ONAF is submitted, which includes completion and submission of all three ONAF sections. For more information on submitting online ONAFs, refer to this user guide.