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 System and Process Changes

This section of our website will assist you in understanding ongoing system and process changes. AmeriHealth is committed to maintaining this site with updated news and information related to these changes as it becomes available. We encourage you to visit this site frequently.

Important Information about System and Process Changes

A letter was mailed to our provider network in June 2013 that outlines potential impacts of business process changes, including changes to the NaviNet web portal and X12 transactions.

AmeriHealth providers in Pennsylvania and Delaware

AmeriHealth providers in New Jersey

For More Information

Below is a Frequently Asked Questions (FAQ) document, which includes answers to inquiries that we have received from participating providers regarding the system and process changes.

Additional information will be posted on this site as details are made available. Important categories related to these changes are included below to help you quickly find the information that you need.

If you have reviewed the FAQ and you still have questions about our system and process changes, please email us.

Claims Submission and Payment

We are working in a dual claims-processing environment until all of our AmeriHealth Pennsylvania membership is migrated to the new platform. During this time, providers will see changes to claims submission requirements and payment for migrated AmeriHealth Pennsylvania members.

>> More about Claims Submission and Payment

X12 Gateway Transition

AmeriHealth migrated X12 transactions from our current X12 Gateway to the Highmark Gateway.

>> More about X12 Gateway Transition

NaviNet® Resources

The NaviNet web portal is undergoing a series of changes and enhancements that will affect your day-to-day operations. AmeriHealth providers will see a difference in the look and feel of the provider portal, as well as in transaction functionality.

>> More about NaviNet Resources

Communication Archive

Below is a link to our communications archive, which includes a complete list of communications regarding system and process changes. We encourage you to visit this page frequently for updated information.

>> Complete Communication Archive

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