SSHP - High Risk Pregnancy Referral Form › content › dam › ...High Risk Pregnancy Center. High...
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HIGH RISK PREGNANCY REFERRAL FORM SilverSummit Healthplan Medicaid Members who are identified as High Risk must be referred to High Risk Pregnancy for an evaluation and ultrasound. Additionally, all high level ultrasounds which includes any ultrasound other than for primary or initial diagnosis of growth, fluid or fetal presentation should be referred to High Risk Pregnancy Center. High Risk Pregnancy Center has 3 locations in Clark County and one location in Washoe County. Members may outreach directly to High Risk Pregnancy for an appointment. No referral is required. High Risk Pregnancy Center https://hrpregnancy.com/ To schedule an appointment, call High Risk Pregnancy at 877-272-4617 2011 Pinto Lane Suite 200 Las Vegas, NV 89106 (Off Charleston & I-15) Fax: (702) 382-3575 9090 W. Post Road Suite 100 Las Vegas, NV 89148 (Near the campus of Southern Hills Hospital) Fax: (702) 946-5411 2845 Siena Heights Drive Suite 350 Henderson, NV 89052 (Near the campus of St. Rose Siena Hospital) Fax: (702) 932-2299 9780 S. McCarran Blvd Suite 1 Reno, NV 89523 Call: 877.272.4617 Fax: (775) 404-0000 As a reminder, please ensure all SSHP Members complete the Notification of Pregnancy. Members can receive rewards through My Health Pays Rewards program. Notification of Pregnancy Rewards Program $50 for Notification of Pregnancy (1 per pregnancy) if completed within the first trimester $25 for Notification of Pregnancy (1 per pregnancy) if completed within the second trimester $20 First prenatal visit (1 per pregnancy) $20 Post-Partum doctor visit (must be completed 4-6 weeks after delivery) $10 For 6 infant well care visits up to 15 months old. (These visits are recommended at 3-5 days old, before 30 days old, and at 2, 4, 6, 9, 12 and 15 months old) Smart Start for Your Baby Rewards Program (to be eligible for this reward, you must notify us if you are pregnant, or prior to having your baby by calling us or submitting a complete Notification of Pregnancy form. $20 – Start Smart For Your Baby program enrollment (1 per pregnancy) $10 – Start Smart For Your Baby program Prenatal (3 claims per reward – max 3 rewards per pregnancy – Max $30 SSHP_HRPRF_03272020 SilverSummitHealthplan.com
Transcript of SSHP - High Risk Pregnancy Referral Form › content › dam › ...High Risk Pregnancy Center. High...
HIGH RISK PREGNANCY REFERRAL FORM
SilverSummit Healthplan Medicaid Members who are identified as High Risk must be referred to High Risk
Pregnancy for an evaluation and ultrasound. Additionally, all high level ultrasounds which includes any
ultrasound other than for primary or initial diagnosis of growth, fluid or fetal presentation should be referred to
High Risk Pregnancy Center. High Risk Pregnancy Center has 3 locations in Clark County and one location in
Washoe County. Members may outreach directly to High Risk Pregnancy for an appointment. No referral is
required.
High Risk Pregnancy Center
https://hrpregnancy.com/
To schedule an appointment, call High Risk Pregnancy at 877-272-4617
2011 Pinto Lane Suite 200
Las Vegas, NV 89106 (Off Charleston & I-15)
Fax: (702) 382-3575
9090 W. Post Road Suite 100
Las Vegas, NV 89148 (Near the campus of
Southern Hills Hospital) Fax: (702) 946-5411
2845 Siena Heights Drive Suite 350
Henderson, NV 89052 (Near the campus of St.
Rose Siena Hospital) Fax: (702) 932-2299
9780 S. McCarran Blvd Suite 1
Reno, NV 89523 Call: 877.272.4617
Fax: (775) 404-0000
As a reminder, please ensure all SSHP Members complete the Notification of Pregnancy. Members can
receive rewards through My Health Pays Rewards program.
Notification of Pregnancy Rewards Program
$50 for Notification of Pregnancy (1 per pregnancy) if completed within the first trimester
$25 for Notification of Pregnancy (1 per pregnancy) if completed within the second trimester
$20 First prenatal visit (1 per pregnancy)
$20 Post-Partum doctor visit (must be completed 4-6 weeks after delivery)
$10 For 6 infant well care visits up to 15 months old. (These visits are recommended at 3-5 days old, before 30 days old, and at 2, 4, 6, 9, 12 and 15 months old)
Smart Start for Your Baby Rewards Program (to be eligible for this reward, you must notify us if you are
pregnant, or prior to having your baby by calling us or submitting a complete Notification of Pregnancy form.
$20 – Start Smart For Your Baby program enrollment (1 per pregnancy)
$10 – Start Smart For Your Baby program Prenatal (3 claims per reward – max 3 rewards per pregnancy – Max $30
SSHP_HRPRF_03272020 SilverSummitHealthplan.com
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