The peer-to-peer process* streamlines workflows, improves cost-efficiencies,
and complies with accreditation requirements. The process was developed with
input from the provider community and offers providers a streamlined process,
along with opportunities to discuss decisions and resolve inquires prior to
initiating a formal appeal.
Online submission
In order to process the peer-to-peer requests quickly and efficiently, be
sure to completely fill out the online peer-to-peer request form, which
includes:
- patient information (i.e., name, reference number/ ID number, and date of
birth);
- requesting physician?s contact information (i.e., name and telephone
number);
- inpatient information (i.e., facility name and telephone number, if
applicable).
Please note that an email address must be provided so we can contact you
with any questions to ensure your request is processed in a timely manner.
The AmeriHealth New Jersey peer-to-peer request form will be
available later in April. The AmeriHealth Pennsylvania peer-to-peer request form is
available now.
Note: This information does not apply to providers contracted with
Magellan Healthcare, Inc.
*Precertifications through AIM Specialty
Health® and CareCore National, LLC d/b/a eviCore healthcare are
not eligible for the peer-to-peer process.
Magellan Healthcare, Inc. manages mental health and
substance abuse benefits for most AmeriHealth members.