Get Obstetrical Needs Assessment Form - Providers - Amerihealth Caritas Pennsylvania. Obstetrical Needs

Completing the Obstetrical Needs Assessment Form is essential for notifying managed care organizations of a person's pregnancy status. This guide provides step-by-step instructions for effectively filling out the form online, ensuring timely enrollment in necessary maternity programs.

Follow the steps to complete the form accurately and efficiently.

1. Select the ‘Get Form’ button to access the Obstetrical Needs Assessment Form, opening it in a suitable form editor.
2. Begin by entering information in the OB/GYN Office Information section, including practice name, phone and fax numbers, provider MAID#, and completion dates for submissions.
3. Proceed to the Member’s Information section. Fill in the user’s full name, date of birth, member ID, health plan, contact numbers, primary and any secondary languages, and hospital choice for delivery.
4. Document pregnancy-related information such as the date of the first prenatal visit, expected date of confinement, methods of calculations, gravidity, and history of pregnancies and abortions.
5. In the middle section, provide information regarding past obstetric complications, current risks, and any active medical or mental health conditions. Be precise when selecting the appropriate checkboxes.
6. Record details surrounding delivery, including date, gestational age, delivery method, birth weight, whether the baby was admitted to the NICU, and other relevant factors.
7. Complete the postpartum visit section after delivery by documenting the visit date, depression screening results, feeding methods, and any discussions regarding contraception and tobacco cessation.
8. Lastly, review the form for completeness, ensuring all sections are filled accurately, and then use the provided options to save changes, download, print, or share the form as needed.

Complete the Obstetrical Needs Assessment Form online today to ensure timely support for maternity care.