A newborn coordinator helps providers with Medicaid eligibility and service issues for a newborn whose birth parent is in HealthChoice. A newborn coordinator can help fix Medicaid eligibility problems for a child enrolled within the first 60 days after birth. Each HealthChoice managed care organization has a newborn coordinator available during business hours.
How a Newborn Coordinator Can Help
A Newborn Coordinator works with the provider’s office, the MCO, and the Maryland Department of Health to:
- Find out if an eligible newborn is in an MCO.
- Work with all parties to resolve eligibility issues involving multiple MCOs.
- Help find a primary care provider for an eligible newborn.
- Request an MCO ID card for a newborn if needed.
- Make retroactive PCP enrollments if needed.
- Help resolve claims for services provided to an eligible newborn.
- Offer general guidance on newborn-related issues to providers and their staff.
- Work with other care providers to help with care delivery and claims payment.
- Coordinate and authorize in-network care when the newborn does not yet appear in EVS or the MCO's system.
- Coordinate and authorize out-of-network care when the MCO doesn’t have a suitable in-network provider.
