For the MCH team to initiate outreach and support activities, identify and address potential barriers to care, and encourage active member participation in their pregnancy health, early notification of pregnancy from providers is essential. This allows us to work collaboratively with our providers to achieve the best possible birth outcomes.
To determine which members require OB care management services, we ask that providers submit the Notice of Pregnancy form (NOP) no later than the second prenatal visit. The NOP form should include the Estimated Date of Confinement (EDC), Gravida/Para (GP) information, risk status, and prenatal records. Please fax all completed NOP forms to 520-874-7026.
Additionally, we accept direct referrals from providers and members for any pregnant member in need of care coordination, regardless of risk factors.
Thank you for your partnership in ensuring the best possible care for our pregnant members.
The directory below is being made available for providers to support in identifying Medication Assisted Treatment (MAT) services for our pregnant and postpartum members.
These are providers located in the state of Arizona, and these providers may or may not be contracted with all the AHCCCS Managed Care Organizations (MCOs). Specialty listing of AHCCCS registered providers will appear and the provider’s Name, Specialty, Address and Phone number will be listed. Providers with multiple office locations will be listed under each location.
At no cost, this phone line connects healthcare providers to perinatal psychiatrists. The line functions in real time, so providers can consult on treatment options for their patients struggling with mental health and substance use disorders.
The attending provider must acknowledge that a pregnancy termination has been determined medically necessary by submitting the Certificate of Medical Necessity for Pregnancy Termination. The form must be submitted with the Prior Authorization request form to obtain the Health Plan Medical Director’s signature. Please refer to the Banner – University Family Care Provider Manual for further guidance on when to submit the certificate.