Pregnancy service - prior authorization information

Pregnancy

PCP’s or obstetricians are required to notify SHP of the first prenatal visit and/or positive pregnancy test within two (2) working days by completing the Pregnancy Notification Form (refer to the Forms Section), whether the pregnancy was identified through medical history, examination, testing or otherwise.

SHP will allow pregnant enrollees to choose in-network obstetricians as PCP’s if the obstetrician is willing to participate as a PCP.

If a pregnant member has not selected a PCP for her unborn child, SHP will assign a pediatrician for the care of their newborn babies no later than the beginning of the last trimester of gestation. If a provider treating a pregnant member for prenatal care decides to terminate the contract with the Plan, SHP will allow the  member to continue care with that provider until completion of the postpartum care.

If the provider knows the recipient is pregnant and that her unborn child does not have a Medicaid ID  number, the provider may have the newborn assigned a number by sending a CF-ES 2039, Medical  Assistance Referral Form to the Department of Children and Families (DCF) regional office. The forms may be downloaded at http://www.dcf.state.fl.us/publications/eforms/es2039.pdf. Or the member may call the  DCF to notify them of her pregnancy and obtain the Unborn ID Number and later call SHP Member Services with the number.

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