Information about the AmeriHealth Quality Management Program is accessible in
the
Quality Management section of our website. AmeriHealth
is dedicated to maintaining the highest standard of care and service for our
members, providers, and the communities we serve. The following information
about our Quality Management Program is available on our website to promote our
standards of care:
Quality Management Program. The description of the AmeriHealth Quality
Management Program includes program goals, objectives, and activities to
improve clinical, network, and service quality.
Member rights and responsibilities. All AmeriHealth members have defined rights
and responsibilities.
Medical record-keeping standards. Well-maintained medical records are critical
to facilitate communication, continuity, coordination, and an effective plan of
care. Accordingly, AmeriHealth standards require that medical records are
maintained in a manner that is current, detailed, and organized as required by
applicable regulatory requirements.
Access and availability standards. AmeriHealth standards ensure that our
managed care networks are adequate to meet the needs of our members with
respect to location and appointment accessibility for primary and specialty
care as well as urgent and emergency care in accordance with applicable
regulatory requirements.
Privacy and confidentiality. AmeriHealth, our contractors, and our affiliates
are required to protect the privacy and confidentiality of our members'
personal and health information in accordance with state and federal regulatory
requirements.
Information about our Quality Management Program and these standards can also
be found in the Provider Manual for Participating Professional Providers
(Provider Manual), which is available through the NaviNet
? web
portal. A paper copy of the Provider Manual can be ordered by submitting an
online request or by
calling the Provider Supply Line at
1-800-858-4728.
Please review the standards listed in this article to ensure that your office
maintains the required access, documentation, and quality care expected of our
network providers.
For more information about our Quality Management Program and our progress in
meeting program goals, please visit our website or contact Customer Service at
1-800-275-2583. Members may request the same
information by calling Customer Service.
NaviNet? is a registered trademark of NaviNet,
Inc.