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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:
BriovaRx Specialty Pharmacy and Infusion Services has become Optum Specialty Pharmacy and Optum Infusion Pharmacy (Pharmacy) P
Vaccinations recommended for adult AmeriHealth members (Medical) P, F, A
AmeriHealth offers language assistance services to help members and their beneficiaries communicate (Quality Management) P, F, A
Avoid documentation cloning (Billing & Reimbursement) P, F, A
Becoming a credentialed professional provider (Administrative) P
Changes to precertification requirements for intravitreal VEGF products effective January 1, 2020 (Medical) P
Help us improve your experience with the Provider Services Call Center (Administrative) P, F, A
AmeriHealth New Jersey to introduce Value Formulary (Pharmacy) P, F, A
Health Coaching: Programs to enhance the coordination of care for AmeriHealth members with health concerns (Health and Wellness) P
Member cost-share information through the NaviNet Open Eligibility and Benefits Inquiry transaction (NaviNet Open) P, F, A
View up-to-date policy activity on our Medical Policy Portal (Medical) P, F, A
Annual notification regarding utilization review decisions  (Quality Management) P, F
Ensure proper routing of CFID audit questions (Administrative) P, F, A
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

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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