January 2021

Limit In-person Visits with Virtual Prenatal Care

Throughout the COVID-19 pandemic, one of Blue Cross and Blue Shield of Illinois’ (BCBSIL's) top priorities is to help keep our members, providers and communities safe. While prenatal care cannot be provided completely by telehealth, providers may be able to provide care to mom and baby while limiting in-person contact and reducing in-person visits through virtual prenatal care.

Below you will find the current plan from the University of Michigan Obstetrics and Gynecology program¹ outlining the intervals for in-person and virtual visits, as well as the recommended medical equipment or interventions for virtual visits that may assist you in developing and implementing your patient’s pregnancy care plan. 

Equipment Recommended for Virtual Visits
Blue Cross Community Health Plans^SM (BCCHP^SM) and Blue Cross Community MMAI (Medicare-Medicaid Plan)^SM members may have over-the-counter (OTC) benefits, which may include some of the items listed below. BCCHP and MMAI members simply call Member Services at 877-860-2837 (TTY 711), 24 hours a day, seven days a week to find out the dollar amount and products available for them. The order will be shipped to the address provided within seven to 10 days.

Blood Pressure Cuff – Any BCBSIL member may obtain a blood pressure cuff from their local pharmacy with a provider prescription. Some Medicaid members may qualify for a blood pressure cuff without cost-sharing by using OTC benefits.

Fetal Doppler – In lieu of a fetal doppler, it is recommended that mothers perform regular “kick counts” to assess for fetal movement and activity. Currently, fetal dopplers are not covered under the OTC benefits.

Bathroom Scale – Some Medicaid members may be eligible to obtain a bathroom scale by using their OTC benefits.

Always check eligibility and benefits first for all BCBSIL members prior to rendering services. This step can help you confirm prior authorization requirements and utilization management vendors, if applicable. If you have any questions on benefits, refer to the member’s ID card for the appropriate contact information.

¹Michigan Medicine, Prenatal Care During the COVID-19 Pandemic, 2020. https://medicine.umich.edu/dept/obgyn/patient-care-services/prenatal-care-during-covid-19-pandemic-prenatal-patient-resources

The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. References to third party sources or organizations are not a representation, warranty or endorsement of such organizations. Any questions regarding those organizations should be addressed to them directly. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.

Checking eligibility and benefits and/or obtaining prior authorization or pre-notification is not a guarantee of payment of benefits. Payment of benefits is subject to several factors, including, but not limited to, eligibility at the time of service, payment of premiums/contributions, amounts allowable for services, supporting medical documentation, and other terms, conditions, limitations, and exclusions set forth in the member’s policy certificate and/or benefits booklet and or summary plan description. Regardless of any prior authorization, pre-notification or benefit determination, the final decision regarding any treatment or service is between the patient and their health care provider.