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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:
Required lead time when updating your provider information (Administrative) P, F, A
Scheduling annual well-care visits (Medical) P
Reminder: Coverage criteria for the annual Synagis (palivizumab) distribution program  (Medical) P, F
Act now! Encourage adults to get flu vaccinations (Medical) P, F, A
New filter option to be introduced within the NaviNet Open Authorization Log  (NaviNet Open) P, F, A
Processes for AmeriHealth Pennsylvania post-service appeals and grievances  (Billing & Reimbursement) P
Introducing the new PEAR portal for managing clinical and financial activities (Medical) P, F, A
New policy criteria for treatment of osteoarthritis of the knee (Medical) P
Changes to precertification requirements for intravitreal VEGF products effective January 1, 2020 (Medical) P
Updated policy for Direct Access to OB/GYN services (Medical) P
Updates to the list of specialty drugs that will require precertification for AmeriHealth New Jersey members (Medical) P, F, A
Updates to the list of specialty drugs that will require precertification for AmeriHealth Pennsylvania members (Medical) P, F, A
Updates to the AmeriHealth Pennsylvania medical benefit specialty drug cost-sharing list for 2020 (Medical) P, F, A
Sign up! Receive news and announcements from AmeriHealth (Administrative) P, F, A
Coverage update for surgical and minimally invasive treatments for urinary outlet obstruction due to BPH (Medical) P
Expanding preventive coverage of HPV vaccine (Medical) 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
Staying connected with you through Provider Engagement Forums (Administrative) P, F, A
$0 cost-share program for certain prescription medications through December for AmeriHealth Pennsylvania members (Pharmacy) P, F, A
New resource available! Use our Demographic Maintenance Guide to help you update your provider demographics (Administrative) P, F, A
Action needed! NaviNet Open email validation  (NaviNet Open) P, F, A
Save the date! Pennsylvania will host Medication-Assisted Treatment Regional Summits this fall (Medical) P

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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