​​Ens​ure proper submission of appeals​

February 27, 2023

​We are seeing a high-volume use of the member appeals fax number to submit non-member related appeal requests. The member appeals fax number should only be used when you are submitting an appeal on the member's behalf. For example, when the member has signed a consent form to have the provider submit the appeal.

The appeal submission procedures are outlined in the Appeals section of the Provider Manual for AmeriHealth New Jersey or AmeriHealth Pennsylvania or the Clinical Services – Utilization Management section of the Hospital Manual for AmeriHealth New Jersey.

As a reminder, please also adhere to the Timely Filing requirements when submitting your request to avoid a rejection for untimely filing.

Thank you in advance for ensuring the appropriate channel is used when submitting future appeal requests.