Maternity Care Services
Applicable to: Banner – University Family Care Plans, ACC and ALTCS
Banner – University Health Plans (B – UHP) requires that quality family planning, pre-pregnancy, pre-natal, and postpartum services are available to every member. Providing excellent care across the continuum of family planning and maternity care, is a critical component in supporting good health of both mother and child.
B – UHP understands that both early and regular pre-natal care are vital to ensuring the best possible pregnancy, delivery, and newborn outcomes. The B – UHP Maternal Child Health (MCH) team offers a multi-disciplinary care management program to assist in the care of pregnant members who are at risk because of medical conditions, social circumstances or compliance and adherence concerns. Our OB care team links expectant mothers with appropriate community agencies and resources such as WIC, parenting classes, shelters, and substance abuse counseling. Care Managers provide support and promote compliance with prenatal care appointments and prescribed medical care regimens.
Receiving early Notification of Pregnancy from providers is the cornerstone to the MCH team initiating our various member outreach and support activities, to identifying and resolving potential barriers to care, and to facilitating the member’s active participation in their pregnancy health. We look forward to partnering with our providers to have the best birth outcomes.
The Notification of Pregnancy form (NOP) is a vital component to determine which of our members need OB care management services. Please submit the Notification of Pregnancy Form to initiate maternity care services no later than the second prenatal visit. A complete Notification of Pregnancy Form (NOP) shall include the Estimated Date of Confinement (EDC), Gravida/Para (GP), Risk Status information and Prenatal records. All Notice of Pregnancy Forms (NOP) need to be faxed to (520) 874-7026.
We also take direct referrals from our providers and members on any pregnant member needing care coordination regardless of risk factors. The NOP Form is available below.
Maternal & Child Health Services Team - Contact Information:
- Michael Riegel, RN, BSN, Medical Management Director, (480) 827-5941
- Heidi Haeder-Heild, LBSW, Senior Manager, (480) 827-5924
- Ana Zavala- Madera, Senior Project Coordinator, (480) 827-5902
Maternity Care Services
Female members have direct access to preventative and well care services from a Primary Care Provider or a Gynecologist within the Contractor’s network without the need for a referral.
Maternity care services include, but are not limited to:
- Identification of pregnancy
- Medically necessary prenatal services
- Treatment of pregnancy related conditions
- Labor and delivery services
- Postpartum care
- Related services such as outreach, education, and family planning services
Pregnancy-Related Forms for Providers
Notice of Pregnancy Form
Submit Notification of Pregnancy Form to initiate maternity care services at the first and no later than the second prenatal visit. A complete Notification of Pregnancy Form (NOP) shall include the Estimated Date of Confinement (EDC), Gravida/Para (GP), Risk Status information and planned place of delivery.
Certificate of Medical Necessity for Pregnancy Termination
The attending provider must acknowledge that a pregnancy termination has been determined medically necessary by submitting the Certificate of Medical Necessity for Pregnancy Termination. The form must be submitted with the Prior Authorization request form to obtain the Health Plan Medical Director’s signature. Please refer to the Provider Manual for further guidance on when to submit the certificate.