Title: OB Deliveries & Newborn Claims Billing Clarification | Sunflower Health Plan
Headings: News
News
SHPBN-2016-086 OB Deliveries & Newborn Claims Billing Clarification
When the Mother is Assigned to Sunflower Health Plan:
Delivery and Newborn Claims
For the Mom's Claim:
When billing for a newborn who does not have a Medicaid ID number:
For the Baby's Claim:
When billing for a newborn who has their own Medicaid ID number:
For the Baby's Claim:
Billing Reminders When Using the Mother’s Beneficiary ID Number
When the Mother is SOBRA or not assigned to Sunflower Health Plan: Newborn Claims
For the Newborn Claim born to a SOBRA Mother:

Content: Z38 ICD10 codes are not for use on the mother's claim
Effective with dates of service beginning January 1, 2015 claims for newborn services billed under the mother’s beneficiary ID will be pended for 45 days pending receipt of the newborn’s beneficiary ID number. If a newborn ID is received, the claim will be denied "EXnB – Deny: Rebill with Newborn Medicaid ID#, Name and DOB" notifying the provider they must submit a corrected claim using the newborn’s ID number, name, and DOB. If no newborn ID is received and the date of service is within 45 days of the newborn’s date of birth, the claim may be paid using the mother’s ID number. If the date of service is not within 45 days of the newborn’s date of birth, the claim will be denied. When billing for a newborn who has their own Medicaid ID number: For the Baby's Claim: Medicaid ID: Use the newborn's Medicaid ID
Patient Name: Use the newborn's first and last name as shown in KMAP or on the ID card
Date of Birth: