Prenatal Incentive Program

$25.00 Reimbursement for ACOG Prenatal Assessment Forms


BMC HealthNet Plan is initiating an American Congress of Obstetrics and Gynecology (ACOG) prenatal assessment form incentive program for all OB/GYN and Family Practitioners providing care to our members during their pregnancy. We are offering providers a $25 incentive to submit a copy of the ACOG prenatal assessment form, completed during the first prenatal visit, to help identify pregnant members early in the pregnancy. Once identified, members will be contacted by care management staff and offered the option to participate in the Sunny Start program. Sunny Start is our care management program for moms and babies to help them get the care they need during and after pregnancy.

Download Prenatal Incentive Submission Form

Incentive FAQ

Who is eligible for the incentive?
All OB/GYN and Family Practitioners that provide care to our pregnant members throughout their pregnancy.

How much is the incentive?
$25 per ACOG prenatal assessment form per member per pregnancy submitted to BMC HealthNet Plan.

Can I send in more than one form for a member?
Yes, however providers will only receive payment once for each member pregnancy.

Initiative FAQ

How do I submit the ACOG form(s)?
ACOG forms can be sent to the following locations:

  • Email (Please send secure):
  • Confidential Fax: 617-951-3426
  • Mail:

    Boston Medical Center HealthNet Plan
    529 Main Street, Suite 500
    Charlestown, MA 02129
    Attn: Care Management Department
  • Contact your Provider Relations Consultant to schedule a visit

Does the ACOG form have to be sent in a specific format?
Yes, please send all ACOG forms with the ACOG form cover page to help ensure incentive payments are addressed to the appropriate provider or provider group. The ACOG prenatal assessment forms can be sent in whichever format is used at the providers’ offices. Please make sure the forms are legible and include a signature, dates and the most recent contact information for the member.

When should the ACOG form be sent?
Please send the ACOG prenatal assessment form as soon as the initial prenatal assessment is complete.

What if the member is new to BMCHP and is in their 2nd or 3rd trimester?
We will accept the ACOG prenatal assessment form at any time in the pregnancy if the member is new to BMC HealthNet Plan. If you identify a member that has recently changed insurance to BMC HealthNet Plan, please send the form in as soon as possible.