Skip to main content

Right Start Prenatal Program Transition for 2023

Date:
August 17, 2022

To: OBGYNs and PCPs

Beginning January 1, 2023, Right Start prenatal and home visiting programs for high-risk pregnancies will no longer be continuing for your Highmark Blue Shield of Northeastern New York patients.

Your Highmark BSNENY patients that are enrolled in Right Start and still need support into 2023 will be transitioned into our High-Risk Maternity Specialty Case Management program.

High-Risk Maternity Specialty Case Management is available for patients who have a history of high-risk pregnancy or may be at higher risk for complications secondary to fertility planning and treatments, or other comorbidities such as:

  • Asthma
  • Diabetes
  • Hypertension
  • Depression
  • Social determinants of health (SDoH) needs

The High-Risk Maternity Specialty Case Management program provides your patients with support throughout their pregnancy as well as postpartum. Patients are screened and referrals can be made to internal behavioral health specialists for postpartum depression if needed. Support is also provided by our Social Work and Wellness teams for pregnancy nutrition and identified SDoH needs.

To refer your patients to the program after January 1, 2023:

  • Log into NaviNet® and access Plan Central
  • Click the Case Management Referral and Inquiry link under Workflows for this Plan to go to the Clinical Care & Wellness Page (CC&W)
  • Click the Create New Referral button under Submit New Referral to CC&W
  • Follow the steps to create and submit the referral

Your patients can also self-enroll into any of our clinical programs by calling the member services number on the back of their member ID card to request case management services.

Recent Articles

  • Provider Resource Center to Replace Legacy Provider Website on February 1, 2023
    Beginning on February 1, 2023, we will be redirecting those visiting our legacy provider website (bsneny.com/provider) to the Highmark Provider Resource Center (PRC). The timing of this transition will occur after all Highmark BSNENY patients have been moved onto Highmark’s system in January 2023. In this article, you can learn more about this change and how to access important resources on the PRC.
  • New Phone Self-Service Tools
    To help reduce Provider Service call wait times, we’ve introduced new self-service phone tools. When you call Provider Service at 1-800-444-4552 or 1-800-950-0051, you will hear new voice prompts to help you access patient information, including claims status, eligibility, and benefits without speaking to a representative.
  • Virtual CME Opportunities
    As you consider how to complete required Continuing Medical Education (CME) before the end of the year, we are happy to offer some new CME opportunities. You can earn up to 6 CME credits online at no cost through Highmark’s Population Health University and Coding and Quality Knowledge College. In this article, you can register for online modules, as well as an October webinar.
  • 2023 Vatica Incentive Payment Changes
    Starting January 1, 2023, incentive payments for Vatica Annual Wellness Visits (AWV) will be paid directly from Vatica Health. Payments will be made monthly. This change creates a more streamlined process and eliminates the possibility of incentive payment discrepancies. Here, you can access updated billing grids and view coding guidance.
  • Utilization Management: Coverage and Denial Processes
    Understanding coverage and denial decisions and knowing the right steps to take after an authorization is denied will help your patient get the right care at the right time. This article provides further guidance on the appeal process after an authorization denial.

Working with Us

Additional Resources

We want to hear from you! Have a topic request for the next Blue Bulletin? Email us

Stay in Touch! Sign up to receive emails for provider news and information