Get Sc Maternity Outcome Authorization Form - Unison Health Plan Home

Filling out the SC Maternity Outcome Authorization Form is an important step for ensuring that maternity-related services are appropriately documented and authorized. This guide provides clear, step-by-step instructions for completing the form online, making the process straightforward and efficient.

Follow the steps to successfully complete the form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Start by entering your Member ID number in the designated field. This information is critical for identifying your enrollment.
3. Input the last four digits of your Social Security number to further verify your identity.
4. Enter your date of birth in the required format. This is important for confirming your eligibility.
5. Fill in your last name and first name as they appear on official documents.
6. Select the name of the hospital where the delivery occurred.
7. If applicable, include the hospital provider number.
8. Identify the UR/CM contact by providing their name.
9. Enter the phone number for the UR/CM contact. Ensure that it is accurate for any necessary follow-ups.
10. Provide the fax number for the UR/CM contact, if available.
11. Fill in the last name and first name of the attending physician.
12. Enter the pediatrician’s name to ensure proper follow-up care for your newborn.
13. Document the date of your newborn's first appointment.
14. Record the actual admission date, the actual delivery date, and the actual discharge date in the specified fields.
15. If applicable, indicate whether you have other insurance, and provide the primary carrier name and policy number.
16. Complete the sections for each birth, such as date of birth, infant's first name, last name, birth time, gender, birth weight, Apgar scores, gestational age, and delivery type.
17. State the discharge information for both mother and baby, including feeding method options.
18. Fill out the mother’s discharge planning details, including home care visit date and doctor’s name if different.
19. Review all entered information for accuracy and completeness.
20. Once all fields are completed, save the changes, download, print, or share the form as needed.

Complete your documents online today for efficient processing!