Maternity Care Management Forms

Notification of a pregnancy and a member’s associated risk factors plays a critical role in ensuring that members are aware of and connected to the services and supports available during pregnancy and the postpartum period.

Provider can submit the Maternity Care Management Form Form through each Managed Care Organization’s provider portal or via fax. Fax numbers for each Managed Care Organization can be found on the form. Submission of the Maternity Care Management Form is supported with an incentive.

To learn more, review the Maternity Care Management Form information from the December 2021 Maternal Health Updates Webinar.

Can’t find what you need? Contact Jona.Bandyopadhyay@tn.gov.