​​Hospital Manual for Participating Hospitals, Ancillary Facilities, and Ancillary Providers – ​AmeriHealth New Jersey​

The Hospital Manual for Participating Hospitals, Ancillary Facilities, and Ancillary Providers (Hospital Manual) is part of a Hospital, Ancillary Facility, or Ancillary Provider Agreement (Agreement) with AmeriHealth HMO, Inc., AmeriHealth Insurance Company of New Jersey, and its affiliates (collectively referred to as "AmeriHealth New Jersey").

The manual was developed to assist participating hospitals, ancillary facilities, and ancillary providers in conducting business with AmeriHealth New Jersey in accordance with the Agreement.

The Hospital Manual is an easy-to-use reference tool, color-coded, and hyperlinked to provide easy access to the information that providers need most. It is updated regularly to provide pertinent information regarding our policies, procedures, and functions.

Providers may request a print version of the Hospital​ Manual by submitting a request through our online order form.

Hospital Manual

  1. Introduction (June 2021)
  2. Gen​eral Information​ (June 2022)
  3. Administrative Procedures​ (December 2021)
  4. Fraud, Waste, and Abuse (October 2021)
  5. Medical Policy & Claim Payment Policy (June 2021)
  6. Clinical Services – Utilization Management (October 2021)
  7. Quality Management​​ (December 2021)
  8. Behavioral Health (October 2021​)​
  9. Billing & Reimbursement for Hospital Services​ (June 2022)
  10. Billing & Reimbursement for Ancillary Services​​ (May 2022)
  11. Disclaimer Information​ ​(June 2021)