​​​​Avoid calling: Take these steps to track claim status

September 27, 2022

​After submitting a claim, please allow up to 30 days for your claim to be processed. After 30 days, you can take the below steps in PEAR Practice Management (PM) to track claim progress.

1)    Use the Claim Search transaction to view the status of your claim: Pending or Finalized.

2)    Once your claim has been finalized, you can choose to submit an investigation to obtain further information. Select the
       “Create New Investigation" button from the claim details page. Keep in mind the following:

a.     ​A claim investigation cannot be opened before the claim reflects a “Finalized' status.

b.     Claim investigations can be submitted within 18 months of the finalized date of the claim.

c.     A maximum of three claim investigations can be submitted via PEAR PM for a single claim. A secondary or
        tertiary claim investigation cannot be opened until the prior investigation reflects a “Closed" status.

d.     Do not submit an investigation for claim edits or claim corrections.

e.     Do not submit an investigation for questions that are not related to claims or claim adjustments. Please call
        PEAR Support at 1-833-444-PEAR (1-833-444-7327) for all non-claim-related questions. 

f.      Claim investigations are not available for AmeriHealth Administrators. Please call 1-800-841-5328 for
        AmeriHealth Administrators.

3)    Once a claim investigation request is submitted, please allow up to 30 days to receive a response. You can review the
        status using the Claim Investigation Search transaction. Investigations are either Open or Closed.

Review the Claims Search and Investigation user guide on the PEAR Help Center for step-by-step instructions.

If you still have questions after completing the above steps, please contact Provider Services at 1-888-YOUR-AH1 for AmeriHealth New Jersey or 1-800-275-2583 for AmeriHealth Pennsylvania.