Healthy pregnancy
We want to help your patients have a healthy pregnancy. Your patients probably have many questions about their pregnancy and the birth of their baby. We’re here to help them get the answers they need.
This page has helpful pregnancy information and material for your patients who are expecting. It’s a great starting point for them to learn about the benefits, services, classes and programs available to them.
Your patients should call the Advocacy Line at 702-691-5665 if they:
- Have any questions about their benefits
- Want to talk to someone about their healthcare experience
- Would like to sign up for our Healthy Pregnancy Plus program, or Breastfeeding class.
Prenatal care
It’s important for your patients to go to the doctor during their pregnancy. Their first doctor’s visit for their pregnancy should be before they’re 12 weeks pregnant. Once they find out they’re pregnant, they should make an appointment with an OB/GYN.
High risk pregnancy
If your patients have high-risk pregnancies, they need to go to the High Risk Pregnancy Center. It has a team of caring experts dedicated to helping your patients have a healthy pregnancy and a safe delivery. There are 3 locations in southern Nevada. Your patients can call 888-381-0695 or visit the High Risk Pregnancy Center website to learn more.
Programs and classes
Healthy Pregnancy Plus program
We support your patients through their pregnancy and the birth of their baby. In our Healthy Pregnancy Plus program, they can learn how to stay healthy during pregnancy and what appointments they need. In addition, they’ll get a $400 reward for completing the program. OB/GYNs also get a $200 reward.
To get the reward, OB/GYNs must:
- see the patient within the first 12 weeks of pregnancy.
- complete the Pregnancy Notification formDownload PDF within 15 days of the first visit.
- fax the completed form to 702-691-5620.
Breastfeeding class
In this class, your patients can learn what to expect when breastfeeding and how to use a breast pump. They’ll also get a breast pump of their own, and other supplies. We’ll help them develop the skills and confidence they need to breastfeed their baby.
Enfamil’s Family Beginnings
Mead Johnson Nutrition develops and manufactures nutritional products for infants and children. Although we encourage our participants to breastfeed, we understand that not everyone will choose to do so. As an additional resource, participants can sign up for Enfamil’s Family Beginnings program (this is optional). The program offers free formula samples, formula discounts, special offers, and nutrition tips and resources.
Labor and birth
Prior authorization
You or your patient must call Nevada Health Solutions at 702-216-1653 for prior authorization if their hospital stay will be longer than:
- 2 days for vaginal delivery
- 4 days for a C-section (cesarean) delivery
C-sections (cesarean)
The body was created to make and have a baby. If your patients don’t have any health issues it’s best for them to have their baby vaginally. A C-section is major surgery and should be avoided if possible.
Copays and costs
We try to keep your patients’ healthcare costs low for their pregnancy and childbirth. If your patients have questions about how much prenatal care is or how much the birth will cost, have them call the Advocacy Line at 702-691-5665. They can also read their Summary of Benefits and Coverage to see an example of what their costs could be.
Copays for pregnancy and childbirth:
Service your patients may need | In-network provider | Out-of-network provider |
---|---|---|
Office visits | No charge | Not covered |
Childbirth/delivery professional services | No charge | Not covered |
Childbirth/delivery facility services | $250 copay per admission | $2,000 copay/admission + 40% coinsurance of allowable charges. Birthing centers are in this tier. |
Ultrasounds and x-rays |
| Not covered |
Loss of Time (LOT) benefit
Your patients can get paid for some of the time they’ll be gone from work due to childbirth. This is called a Loss of Time benefit.
To get their Loss of Time benefit, your patients should:
- Fill out their part of the Loss of Time formDownload PDF.
- Have you fill out your portion of the form. Don’t charge your patients to fill out this form. It’s part of our contract.
- Have their Human Resources (HR) department fill out its part of the form.
- When complete, you, your patient, or their job can send the form to our Customer Service office.
Breastfeeding support and breast pumps
Your patients can get breastfeeding support and a breast pump for no copay. They have several options:
Attend our breastfeeding class
They’ll get a breast pump and other supplies in the class. A professional lactation consultant will show them how to set up and use the pump. They’ll also give your patients tips from their personal experience with breastfeeding. Follow this link to learn more about our breastfeeding class.
Pick up a breast pump
If your patient has had a baby in the last 4 years and doesn’t want to attend our class, they can pick up a breast pump once they’ve reached their 3rd trimester. Please have your patients call our Advocacy Line at 702-691-5665 to let us know they’re coming.
Get breastfeeding help for no copay
Your patients can get a 1 hour and 30-minute visit with a breastfeeding professional for no copay. During this visit they can talk about any issues or questions they have.
Your patients can call these breastfeeding professionals if they have problems with breastfeeding or pumping. They can also make a personal appointment:
Advanced Breastfeeding Support of Las Vegas
- Telephone: 702-764-9290
- Website: Advanced Breastfeeding Support of Las Vegas
ZtoA Lactation Advising
- Telephone: 702-425-2791
Finding a pediatrician
It’s important for your patient to choose the right pediatrician for their baby. They should pick an in-network pediatrician before the baby arrives. Your patients’ baby will need to go to the pediatrician in the first week after birth.
Your patients can take their baby to a pediatrician at the Culinary Health Center or one of our in-network providers.
To find a pediatrician, they can:
- Call the Culinary Health Center at 702-790-8000
- Or choose one of our in-network pediatricians
Health insurance
Once your patients’ baby is born, they should make sure he or she has health benefits. They can add their baby to their health insurance plan within 30 days of birth. A birth certificate is needed to enroll their newborn as a dependent.
Your patients have 30 days after birth to enroll their newborn as a dependent. They should be sure to bring the baby’s birth certificate to our Customer Service office.
Getting care after the baby is born
Your patients should:
Get help with their feelings and emotions
Your patients may have many emotions after they have a baby. They’ll feel joy and excitement, but they may also experience sadness, fear or anxiety. If they have extreme sadness, anxiety or exhaustion that makes it hard to do daily activities, it’s important for your patients to get help right away. Encourage your patients to talk to you or to call:
- Harmony Healthcare: 702-251-8000
- Human Behavior Institute: 702-248-8866
Consider their birth control options
After your patients have a baby, they may want to talk to you about birth control. Your patients have many options when it comes to birth control. Most birth control is available for no copay. Talk to your patients about their birth control options at their 6-week postpartum checkup.
Get back to a healthy weight and shape
If your patients have issues losing the weight they gained during pregnancy, we have a program that can help. Our Culinary Healthier U program offers a personal nutrition plan for your patients. They can see a registered dietician up to 26 times per year as part of the program.