AmeriHealth will be transitioning its claims processing system to the Highmark
platform for AmeriHealth Pennsylvania members. This transition will help us to
gain efficiencies, lower operating costs, and add new capabilities that enhance
the overall customer experience. The Highmark platform will be used to handle
core processing functions, such as enrollment, claims, and billing for
AmeriHealth Pennsylvania members.
Note: This communication does not impact AmeriHealth Delaware or AmeriHealth
New Jersey members.
[
]Dual claims-processing environment until mid-2015[
]
The migration of AmeriHealth Pennsylvania membership to the new platform will
be completed in stages, generally based on when the customer/member?s contract
renews. The overall migration schedule is not yet final, but we anticipate
migrating business throughout 2014 and ultimately transitioning all claims
processing to the new platform by mid-2015.
During the migration we will be working with you in a dual claims-processing
and business operating environment until all AmeriHealth Pennsylvania business
is on the new claims processing system. In other words, as we transition to the
new platform, we will process a larger proportion of claims and business
transactions on the new platform as AmeriHealth Pennsylvania members are
migrated. We will continue to process claims and conduct business transactions
on the current platform for AmeriHealth Pennsylvania members that have not yet
been migrated.
[
]Keeping you informed[
]
We are committed to working closely with our network physicians and hospitals
to provide continued information, support, and necessary training during this
migration of AmeriHealth Pennsylvania members to the new platform.
In order to keep you informed of the upcoming changes, we will be publishing an
increased volume of communications in Partners in Health Update to outline any
changes that may affect your day-to-day operations. In addition, we have
created a new section on our Provider News Center website, called [
]Upcoming System and
Process Changes[]. This site is dedicated to news related to this
transition and contains a Frequently Asked Questions document for your
reference.
We ask that you read each edition of our newsletter carefully and check this
site frequently for updated information. Additional communication channels may
include direct mail, the NaviNet[
]?[] web portal, our website,
emails, and face-to-face provider education.
We have already begun to engage and educate trading partners and clearinghouses
on the upcoming EDI changes. Please be sure to check with your third-party
vendors to see if changes to your current processes are necessary.
We will provide comprehensive communications and tools to support our
AmeriHealth Pennsylvania members and participating providers before, during,
and after the transition to the new platform. If you have questions related to
the transition, please [
]email[] us.
[
NaviNet® is a registered trademark of
NaviNet, Inc.
]