Newborns. 4.2.5.1 When a child is born to a mother enrolled in Centennial Care, the hospital or other provider shall complete a Notification of Birth, MAD Form 313, or its successor, prior to or at the time of discharge. HSD shall ensure that upon receipt of the MAD Form 313 the eligibility process is immediately commenced and that upon completion of the eligibility process the newborn is enrolled into his or her mother’s MCO.
Newborns. (1) Mother Enrolled with the MCO under this Contract. Eligible newborns born to mothers enrolled in the MCO under this Contract will be enrolled in the same MCO as the mother for the birth month in accordance with STATE policies and procedures, unless the newborn at the time of enrollment meets one of the exclusion reasons listed in section 3.1.1(C).
Newborns. 3.2.2.7.1 Newborns born to mothers who are DSHP or DSHP Plus members at the time of the child’s birth will be Enrolled in their mother’s MCO. If the mother is not Enrolled with an MCO but the child is eligible for Medicaid or CHIP, the birth is covered by fee-for-service Medicaid or CHIP, and the child and the mother will be Enrolled in the same MCO.
Newborns. The STATE will pay to the MCO a Capitation Payment for the birth month of an eligible newborn Enrollee if the mother was enrolled in the MCO during the month of the Child’s birth and eligibility is established for the Child. Payment for succeeding months will be determined pursuant to section 3.1.3,
Newborns. Babies born to SCHIP members are not automatically eligible. A separate application must be filed and an eligibility determination must be made by SCDHHS. See the Policy and Procedure Guide.
Newborns. For the Traditional Attribution Cohort, children born to an Attributed Member mother after September 30 prior to the Performance Year, will not be attributed to Contractor in the Performance Year. For the Expanded Attribution Cohort, children born to an Attributed Member mother after October 30 prior to the Performance Year will not be attributed to Contractor in the Performance Year.
Newborns. 4.2.6.1 When a child is born to a mother enrolled in Turquoise Care, the hospital or other Provider shall notify the HCA of the child’s birth. Hospitals or other Providers shall notify HCA by either using the electronic process available through the Baby Bot program (or its successor) or by completing a Notification of Birth, MAD Form 313 (or its successor) prior to or at the time of discharge. Upon receipt of the notification of the child’s birth, HCA shall ensure that the eligibility process is immediately commenced and that upon completion of the eligibility process the newborn is enrolled into their mother’s MCO.
Newborns a) The Passenger may travel after 48 hours from birth if he was full-term (born at 38 weeks gestation or later) and no complications occurred (during pregnancy, birth and since birth) ;
Newborns. If there are siblings, the newborn will be assigned to the sibling=s PCP. - If there are no siblings and the mother is a BJC Global Risk Member, the baby will be assigned to a physician within the appropriate BJC network, based on the mother's zip code. - The physician will be notified in writing within five (5) business days of the automatic assignment of the newborn to that physician=s panel. A copy of the notification will be sent to the appropriate network Utilization Management Department at the same time. - If the subscriber is a BJC Global Risk Member, and the mother is not a GHP Member, the subscriber should be requested to select a PCP at the time he/she notifies GHP of the need for coverage. If necessary, the newborn can be automatically assigned to the appropriate network as above. Coordination of benefits information should be included in the eligibility file and COB guidelines followed in the processing of claims.
Newborns. PPG shall provide Covered Services to a child born to a Member for the month of birth and the following month. For a child born in the month immediately preceding the mother’s membership. PPG shall provide Covered Services to the child during the mother’s first month of enrollment. No additional Capitation Compensation will be made to PPG for the child for such periods under these circumstances.
