Maternity Case Management

Reduces complications of high-risk pregnancies

Maternity Case Management A high-risk pregnancy, such as multiple births or a birth anomaly, can be a source of extreme stress and anxiety for expectant parents and result in high-cost claims for the health plan. American Health’s Maternity Case Management supports members through this difficult time and helps lower the risk of complications in pregnancy and delivery. Our nurses average 20 years of maternity and neonatal experience. We engage with all key participants as early as possible following identification or diagnosis to assist in the following areas:

  • Education
  • Immediate intervention as needed
  • Adequate preparation and planning
  • Treatment or care facilitation
  • Identification of support groups and systems
  • Providing follow-up and reporting to clients

 

In addition to reducing the risk of additional birth complications, we offer savings to benefit plans by:

  • Minimizing future complications through health management and continuous assessment
  • Providing network steerage
  • Negotiating costs for home health care services if needed
  • Referring cases to Neonatal and Pediatric Case Management after birth, if necessary
  • Reducing the number of work hours lost that result from complications during pregnancy and/or birth

Click here to see our Maternity Case Management key statistics.

 

Product Highlights

  • Dedicated nurses interact on behalf of mother, child and family, offering a complete support network
  • By reducing pre-term births, we have a positive impact on claims costs
  • Cost savings from price negotiations of services and use of alternative settings or services
  • Extensive patient and family education and support through pregnancy and delivery
  • Seamless transition from Maternity Management program when necessary


Testimonials

  • American Health Holding has been a valued partner for over 12 years. We find them to be very helpful and responsive, especially working with their Case Management department.
    Patty Darrow
    RN, BSN, CCM
    Leggett & Platt Carthage, MO
  • American Health's Utilization Review service and iSuite medical management software provides our claims processors with easy access to all the precertification information necessary. The Case Management team is thorough, responsive, and a great resource for our staff and our members.
    Mike Jacobson
    Fund Administrator
    National Automatic Sprinkler Industry Landover, MD
  • American Health is very easy to work with. Their iSuite access provides all the detail we need to process claims and respond to inquiries from providers, members and stop loss carriers. American Health is responsive to our requests and keeps our office informed of potential large claims, etc.
    Administrative Office

  • American Health Holding has been a strategic partner of Fox-Everett for many years. From the onset of our relationship, they have demonstrated their depth of knowledge in case management for us, our reinsurance carriers and our many clients with self-funded medical plans. They have the flexibility to provide services for our clients that are not aligned with their core business; they have provided an onsite nurse for our TPA, which places expert clinical knowledge right in our workplace, and they perform more as an extension of our business than as a "vendor."
    Nita Miller
    Executive Vice President
    Fox-Everett, Inc. Ridgeland, MS
  • The staff at American Health is a valuable resource to our claims administration team. Anything our team at MEBA needs, whether it be questions regarding a precert or the more complex details of a high-cost member in Case Management, the American Health staff is always helpful and knowledgeable.
    Patty Kelly

    MEBA Benefit Plans Baltimore, MD