Get Maternity Notification Online

This guide provides clear and comprehensive instructions for users on how to properly complete the Maternity Notification Online. By following the steps outlined below, users can ensure that their information is accurately submitted for processing.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to access the Maternity Notification Online. Upon clicking, the form will be available for you to complete in the editor.
2. Begin by filling out the member information section. Provide your name, subscriber ID number, address, and Medicaid number. Ensure all details are correct and up-to-date.
3. Enter your date of birth, home phone number, cell phone number, and emergency contact information. This step is crucial for ensuring timely communication.
4. Complete the expected date of confinement (EDC), gravida (number of pregnancies), and para (number of births), including details on term, preterm, and any abortions (AB).
5. Fill out weight (WT) and height (HT), along with any current medications you are taking. This information is vital for your healthcare provider.
6. Indicate your planned delivery site clearly, ensuring that the location is accurate for future reference.
7. In the provider information section, enter the date of your initial office visit and complete the provider's name as well as their National Provider Identifier (NPI).
8. Provide the name and address of the office or clinic you are visiting, including the city, state, and ZIP code. Also, include the phone and fax numbers for direct communication.
9. Review the list of medical conditions and check all that apply to your current health status, ensuring you include any psychosocial risks and specify any substances used if applicable.
10. Fill in the name of the person completing the form and the date of completion. This is essential for verification purposes.
11. Once all information is complete and reviewed, proceed to save your changes. You can also download, print, or share the form as needed.

Start completing your Maternity Notification Online today to ensure all necessary information is submitted accurately.