09/27/2022
The following article provides information about the importance of communication between health care professionals and their patients and care documentation during a patient’s pre-pregnancy, pregnancy, and postpartum medical journey. Federal Employee Program ® (FEP®) members should be encouraged to establish early appointments for prenatal care. Providers should be notified immediately at time of discharge to facilitate the timely scheduling of post-partum exams. This ensures continuity of care and to inform the member of next steps. This is an ongoing process, not a one-time follow-up encounter.
Post-partum visits are recommended to be scheduled before discharge from the hospital. Written and/or electronic instruction is beneficial to the health of the member and the child. Coordination of care is best achieved when providers help members anticipate and follow through with transitions of care and between settings. When providing care, please document the following information in the patient’s chart to help ensure effective coordination and continuity of care1:
Prenatal Visit in First Trimester
- Prenatal risk assessment, including the diagnosis of pregnancy, complete medical and obstetrical history, and physical exam as referenced in the American College of Obstetrics and Gynecology (ACOG) Form
- Prenatal lab reports Ultrasound, estimated date of delivery (EDD)
- Documentation of prenatal risk and education/counseling
Post Postpartum
- Documentation of a postpartum visit on or between 7 to 84 days after delivery. Postpartum office visit progress notation that documents comprehensive postpartum exam which may include an evaluation of weight, blood pressure, breast exam, abdominal exam, and pelvic exam.
- Best practice supports provider staff calling member within one week after delivery to schedule postpartum follow-up visit.
Thank you for your help supporting continuity of care and improved quality outcomes for our members.
1Prenatal and postpartum care (PPC). NCQA. Retrieved September 6, 2022, from https://www.ncqa.org/hedis/measures/prenatal-and-postpartum-care-ppc/
The information in this article is being provided for educational purposes only and is not the provision of medical care or advice. Physicians and other health care providers are to their own best medical judgment based upon all available information and the condition of the patient in determining the best course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations, and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.