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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:
ICD-10 in Action: Chapter-specific guidelines (Billing & Reimbursement) P, F, A
Changes to the annual Synagis (palivizumab) distribution program  (Medical) P, F
Enhanced claim edits to align with industry standard billing rules for injectable drugs and biological agents beginning September 1, 2019 (Billing & Reimbursement) P, F, A
Use CAQH to update your practice information in our directory (Administrative) P, F, A
Now in effect: Enhanced claim edits to align with industry standard billing rules for DME and P&O billing providers  (Billing & Reimbursement) A
New claim payment policy for multiple therapies  (Medical) F
No cost-share for Narcan and naloxone for AmeriHealth New Jersey members to continue in 2020 (Pharmacy) P, F, A
No cost-share for Narcan and naloxone for AmeriHealth Pennsylvania members to continue in 2020 (Pharmacy) P, F, A
Billing and cost-sharing for individuals enrolled in the Qualified Medicare Beneficiary program (Billing & Reimbursement) P, F, A
AmeriHealth New Jersey telemedicine services policy and information on collecting member copayments  (Administrative) P
Required lead time when updating your provider information  (Administrative) P, F, A
View up-to-date policy activity on our Medical Policy Portal (Medical) P, F, A
AmeriHealth refreshes its branding with a new look (Administrative) P, F, A
Health Coaching: Programs to enhance the coordination of care for AmeriHealth members with health concerns  (Health and Wellness) P
Updated InterQual Criteria for 2019 (Medical) P, F, A

NaviNet® Open 

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

NaviNet Open

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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