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 Partners in Health UpdateSM

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View the latest news and information specific to the AmeriHealth-participating provider community below:
Suicide: A concern for all health care providers – Part 2 (Quality Management) P
Changes coming to application of Modifier 59 in 2019 (Billing & Reimbursement) P, F, A
Now in effect: Precertification requirement for non-emergent inpatient transfers, including ambulance transport (Administrative) F
Reminder: Proper submission of your MAT recognition form and waiver (Pharmacy) P
New Select plans offered in the AmeriHealth New Jersey consumer market (Products) P, F, A
Reminder: Online PreCheck MyScript tool provides insight into member pharmacy benefits (Pharmacy) P, F, A
Changes to the management of CAPS drugs now in effect (Medical) P, F
Updated payer ID grids now available for AmeriHealth New Jersey (Billing & Reimbursement) P, F, A
Frequency limit established for trigger point injections for myofascial pain syndrome (Medical) P
Updated AmeriHealth Pennsylvania medical benefit specialty drug cost-sharing list now in effect (Medical) P, F, A
Updated list of specialty drugs that require precertification for AmeriHealth New Jersey members now in effect (Medical) P, F, A
Updated list of specialty drugs that require precertification for AmeriHealth Pennsylvania members now in effect (Medical) P, F, A
New policy on pediatric intensive day feeding program (Medical) P
Reminder: Updates to the AmeriHealth New Jersey telemedicine services policy and information on collecting member copayments  (Administrative) P
Updated Provider Services call center holiday hours (Administrative) P, F, A
View up-to-date policy activity on our Medical Policy Portal  (Medical) P, F, A
Required lead time when updating your provider information (Administrative) P, F, A
Outbreak of life-threatening coagulopathy associated with synthetic cannabinoids use (Medical) P
Reminder: AmeriHealth New Jersey product name change (Products) P, F, A
Reminder: Enhanced claim edits to support correct coding principles and important information about self-funded groups (Billing & Reimbursement) P, F, A
Reminder: New accreditation requirement for office-based varicose vein procedures (Quality Management) P
2018-2019 Clinical Practice Guideline Summary now available  (Quality Management) P

NaviNet Resources 

To help you navigate our secure, online provider portal and various transactions, we have created a central location for a variety of NaviNet resources, including user guides, webinars, and a communications archive.

NaviNet Resources


Opioid Awareness

We have created a repository of tools and resources to assist you in managing your patients who are prescribed opioid medications.

Opioid Awareness Resources


Utilization Management

Certain utilization review activities are delegated to different entities. Here you will find detailed information on our utilization management programs and common resources used among them.

Utilization Management


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