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Anthem Blue Cross : Prenatal Program

Prenatal Program


The Future Moms/ Maternity Management prenatal program helps our pregnant members learn the value of early prenatal care to the health of every mom-to-be and her baby. 
An important component of the prenatal program is the early identification of pregnant women. When you know a patient is pregnant, complete the Pregnancy Notification Report Form (PNR) immediately after the patient’s visit and return it to us by fax at 1-800-551-2410. 
Anthem Blue Cross has an online resource for you to submit pregnancy notifications, which can be used in place of the current paper Pregnancy Notification Report forms. Click here to access the online form Online Pregnancy Notification Form
Once you have submitted a PNR for your patient, we will send her a packet of educational materials. The packet includes information on nutrition, warning signs, alcohol, tobacco and substance use, breastfeeding, postpartum care and other pregnancy related topics.  
In addition, our program offers your patient prenatal, breastfeeding and parenting classes and connects her to social and care management and obstetric home care services. We will also remind her to get a postpartum exam and give her a reward when she gets the exam within 21 to 56 days after childbirth.  
Prenatal Toolkit 

Pregnancy Notification Report Form (PDF)

Pregnancy Assessment Form: Initial (DOC)

Pregnancy Assessment Form: 2nd Trimester (DOC)

Pregnancy Assessment Form: 3rd Trimester (DOC)

Steps to take for Primary Care Physicians and Obstetricians

Breastfeeding Promotion

Women, Infants, and Children (WIC) Program

Importance of Breastfeeding

Breastfeeding Directory

Elimination of Non-medically Indicated (Elective) Deliveries Before 39 Weeks Gestational Age Toolkit (March of Dimes website; marchofdimes.com)

Steps to take for Primary Care Physicians and Obstetricians
Steps to take:  
Confirm a diagnosis of pregnancy Anthem Blue Cross State Sponsored Business members.
Orient the Medi-Cal patients to CPSP, advise what services are available, and document the patient's acceptance or refusal.
If the patient accepts CPSP, you can provide the services or refer out to a source. Ask for copies of the assessments to put into the patient's chart.
SB 889 requires every provider of prenatal care to offer HIV counseling and testing to every pregnant woman during her prenatal care. The law requires documentation that patients were offered HIV counseling, testing and information. Please document in the patient's chart.
Refer the patient to the Women, Infant, and Children (WIC) supplemental nutrition program.
Refer the patient to Anthem Blue Cross to register for a Prenatal, Breastfeeding, and/or Childbirth class. (888) 285-7801 for Los Angeles County, or (800) 407-4627 for all other counties.
Complete a Pregnancy Notification Report and fax to (877)-848-0147.
Customer Care Associates may now ask you for the prenatal information over the phone during routine customer service calls.
If the patient's pregnancy becomes high risk at any time during her prenatal care, please notify Anthem Blue Cross at (805)-384-7656.
If a patient has questions about lactation or breastfeeding please refer them to Anthem Blue Cross’ Breastfeeding Support Line at (800) 231-2999. A registered nurse is available 24 hours a day, 7 days a week to answer questions and provide support.
If you have questions, please contact the Prenatal Program at (805)-384-7656.
Breastfeeding Promotion
Anthem Blue Cross supports the Department of Health Services policy regarding promotion, education, counseling and provision of medically necessary breastfeeding related services. Anthem Blue Cross has adopted the national Healthy People 2010 goal to increase breastfeeding initiation at delivery to at least 75% of all mothers and achieve at least 50% continuation of breastfeeding for six months. The following points summarize the policy for breastfeeding education and counseling and the provision of medically necessary breastfeeding related services.  

Breastfeeding is recognized as the preferred method of infant feeding by the American Academy of Pediatrics, the American College of Obstetrics and Gynecology, and the American Public Health Association.

Breastfeeding should be encouraged for all pregnant women unless it is not medically appropriate.

Providers must refer all Anthem Blue Cross Medi-Cal pregnant and breastfeeding members to the Women, Infants, and Children (WIC) Supplemental Nutrition Program in their area.

Pregnant members should be referred to Anthem Blue Cross breastfeeding classes prior to delivery by calling Anthem Blue Cross Member Services at (888) 285-7801 for LA County and (800) 407-4627 for all other counties.

Providers may not provide formula samples, coupons, or materials from infant formula companies to Anthem Blue Cross breastfeeding or pregnant members.

All materials given to patients should be screened for negative or contradictory messages about breastfeeding.

Lactation management aids are a covered benefit for Anthem Blue Cross State Sponsored Business members. Hand held breast pumps can be obtained via prescription without prior authorization.

Electric breast pumps are available for medical necessity for Anthem Blue Cross State Sponsored Business members with a provider referral and prior authorization. Contact the Utilization Management Department at (888) 831-2246.

Arrangement for the provision of human milk for newborns must be made if the mother is unable to breastfeed due to medical reasons, and the infant cannot tolerate or has medical contra-indications to the use of any formula, including elemental formulas. The Mother's Milk Bank of Santa Clara Valley Medical Center is the only human milk bank in the State of California. The Mother's Milk Bank can be contacted at (408) 998-4550.

Women, Infants, and Children (WIC) Program
The California Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a supplemental food and nutrition education program. It serves low-income pregnant, breastfeeding, and postpartum women, and infants and young children who are at nutritional risk.  
The purpose of the WIC program is to prevent health problems and to improve the health of program participants during critical times of growth and development. It is unique among federally administered food assistance programs because it provides specific supplemental nutritious food and nutrition education to a specific target population as an adjunct to ongoing health care.  
To be eligible for WIC, an individual or family must have income at or below 185 percent of the federal poverty level. In addition, the person must reside in the local agency’s geographic service area and be at nutritional risk as determined by a health professional. Finally, the individual must be categorically eligible as a:  

Pregnant woman

Breastfeeding woman up to 1 year after childbirth

Postpartum woman up to 6 months after childbirth

Infant: 0 to 1 year of age

Child: 1 to 5 years of age

The WIC program provides services in all 58 counties through 82 local WIC agencies, of which 40 are local health jurisdictions and 42 are private, nonprofit agencies. In the aggregate, these local agencies operate more than 600 WIC clinics statewide.  
California operates the nation’s largest WIC program. It is 100 percent federally funded through the U.S. Department of Agriculture (USDA). In SFY 1995-96, the California WIC Program spent approximately $825,476,000. Of that amount, $666,791,000 was spent on food (this includes $184,000,000 received as manufacture rebates), and $158,685,000 spent on nutrition education, breastfeeding promotion and state and local agency program administration.  
To assist your patients with their enrollment in the WIC program, you will need to indicate the following items on their WIC form:  

Height and weight

Hemoglobin or Hematocrit

Confirmation of pregnancy (e.g., estimated date of confinement)

Referral forms can be requested from local WIC agencies or by calling the State WIC Branch at (800)-852-5770.  
Importance of Breastfeeding
Human milk is uniquely suited for human infants.  

Human milk is easy to digest and contains all the nutrients that babies need in the early months of life.

Breast milk contains factors that help infants grow and mature.

Factors in breast milk protect infants from a wide variety of illnesses.

Breast milk contains antibodies specific to illnesses encountered by each mother and baby.

Fatty acids, unique to human milk, may play a role in infant brain and visual development.

In several large studies, children who have been breastfed had a small advantage over those who have been artificially fed when given a variety of cognitive and neurological tests, including measures of IQ.

Breastfeeding saves lives.  

Lack of breastfeeding is a risk factor for sudden infant death syndrome (SIDS).

Human milk may protect premature infants from life-threatening gastrointestinal disease.

Breastfeeding infants are healthier.  

Infants who are exclusively breastfed for at least 4 months are half as likely as artificially (milk or milk substitute other than mothers’ milk) fed infants to have ear infections in the first year of life.

Breastfeeding reduces the incidence and lessens the severity of bacterial infections such as meningitis, lower respiratory infections, and bacteremia in infants.

Breastfeeding is protective against infant botulism.

Evidence suggests that exclusive breastfeeding for at least two months protects susceptible children from Type I insulin dependent diabetes mellitus (IDDM).

Breastfeeding may reduce the risk for subsequent inflammatory bowel disease and childhood lymphoma.

Breastfed infants are less likely to have diarrhea.

Women who were breastfed as a child are less likely to develop multiple sclerosis.

Breastfeeding helps mothers recover from childbirth.  

Breastfeeding helps the uterus shrink to its pre-pregnancy state and reduces blood loss after delivery.

Mothers who breastfeed for at least three months may lose more weight than bottle-feeding mothers.

Breastfeeding mothers usually resume their menstrual cycles 20 to 30 weeks later than bottle-feeding moms.

Breastfeeding keeps women healthier throughout their lives.  

Breastfeeding reduces the risk of breast and ovarian cancer.

Breastfeeding may reduce the risk of osteoporosis.

During lactation, total cholesterol, LDL cholesterol, and triglyceride levels decline while the beneficial HDL cholesterol level remains high.

Breastfeeding is economical.  

The cost of artificial milk has increased 150 percent since the 1980s.

If no California infants were breastfed, the cost of artificial baby milk would exceed $400 million per year.

Breastfeeding reduces health care costs.

Breastfeeding is environmentally sound.  

Unlike artificial baby milk, breastfeeding requires no fossil fuels for its manufacture or preparation.

Breastfeeding reduces pollutants created as by-products during the manufacture of plastics and artificial baby milk.

Breastfeeding reduces the burden on our landfills.

Breastfeeding Promotion Committee Report to the California Department of Health Services Primary Care and Family Health  
If you would like more information about breastfeeding, our Prenatal Program or prenatal education please contact Anthem Blue Cross State Sponsored Business at (888) 285-7801 in Los Angeles County, or (800) 407-4627 in all other California counties, and ask for the Prenatal Project Coordinator.  
Thank you for continuing to provide quality health care for our members.  

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Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association.