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For your convenience, we recently published the following standard fee
schedules (effective September 1, 2015, unless otherwise noted) on AmeriHealth
NaviNet Plan Central for covered services provided to AmeriHealth Pennsylvania
members:
- Ambulatory Surgical Center (effective July 1, 2015)
- Capitation – Certified Registered Nurse Practitioner
- Capitation – Primary Care Physician
- Chiropractic
- Drug (effective July 1, 2015)
- Podiatrist
- Registered Dietitian
- Retail-Based Clinic
- Standard Physician Fee Schedule
To access these documents, select
AmeriHealth from the Workflows menu,
and then go to the Fee Schedules section.
Allowance Inquiry transaction
To look up the rate for a specific code, use the Allowance Inquiry
transaction on the NaviNet web portal. To do so, go to AmeriHealth NaviNet Plan
Central, select Claim Inquiry and Maintenance from the AmeriHealth
Workflows menu, and then select Allowance Inquiry. For step-by-step
instructions on how to use this transaction, refer to the user guide available
in the NaviNet
Resources section of our Provider News Center.
Note: The Allowance Inquiry transaction returns current rates for
professional providers only. The reimbursement rates that go into effect
September 1, 2015, will be available through this transaction on or after this
effective date. Provider payment allowances are for informational purposes only
and are not a guarantee of payment.
NaviNet is a registered trademark of NaviNet, Inc.
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