HealthChoice Newborn Coordinator

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.​​​​​