Later this year AmeriHealth will be transitioning claims processing for New
Jersey commercial members to the Highmark platform, following the successful
transition of AmeriHealth New Jersey Medicare Advantage members earlier this
year.
This transformation of our core operating system to Highmark is the engine
that will help us become a more nimble, innovative company. It will keep us and
our industry partners well-positioned for the future in an ever-changing and
competitive landscape. Further, the transition will continue to help us to gain
efficiencies, lower operating costs, and add new capabilities that enhance the
overall customer experience.
Dual claims-processing environment
The migration of commercial AmeriHealth New Jersey membership to the new
platform will be completed in two stages:
- On September 1, 2015, a smaller subset of commercial New Jersey members
will be migrated to the new platform.
- On October 1, 2015, all remaining commercial New Jersey members will be
migrated to the new platform.
Upon completion of both stages on October 1, 2015, all AmeriHealth claims
processing will be on the new platform. Until then we will continue working
with you in a dual claims-processing environment. In other words, we will
process claims on the new platform for AmeriHealth Pennsylvania members and
AmeriHealth New Jersey Medicare Advantage members, and we will continue
processing commercial New Jersey member claims on the current platform until
the member?s migration date.
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 New Jersey 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
UpdateSM to outline any changes that may affect your day-to-day
operations. In addition, you can find dedicated news related to this transition
in the System and Process Changes section of our
Provider News Center. Additional communication channels may include the
NaviNet® web portal, our website, emails, and face-to-face
provider education.
We have already engaged and educated 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.
If you have questions related to the transition, please contact us at
1-888-YOUR-AH1 (1-888-968-7241).
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