We would like to remind you of the urgent care benefit
available for most AmeriHealth Pennsylvania members.
This benefit allows AmeriHealth Pennsylvania
members to receive services for urgent medical issues
that do not require the advanced medical services
of the emergency room/department (ER) when their
physician is unavailable. Generally, urgent care is
categorized as medically necessary treatment for a
sudden illness or accidental injury that requires prompt
medical attention, but is not life-threatening and is not
an emergency medical condition, when a member?s
primary physician is unavailable.
Eligible AmeriHealth Pennsylvania members can
receive urgent care in the following places:
- Urgent care centers. Urgent care centers are
staffed by board-certified physicians who can provide
medically necessary treatment for a sudden illness or
injury that is not life-threatening.
- Retail health clinics. Retail health clinics are staffed
by certified registered nurse practitioners trained
to diagnose, treat, and write prescriptions (when
clinically appropriate) for common illnesses and
medical conditions. Local supervising physicians are
on call during clinic hours of operation to provide
guidance and direction when necessary.
Approved urgent care centers and retail health clinics
can be found on our Retail Heal Clinics page.
These approved providers may treat members
without a referral or authorization.
You may want to print out a list of the approved urgent
care centers and retail health clinics in your area to
keep on hand and share with the staff who handle
after-hours calls. This list may be instrumental in cases
when a member requires urgent medical attention, but
your office is closed and ER care is not necessary.
Note: Not all members are eligible for the urgent care
benefit. As always, continue to check the NaviNet®
web portal for member eligibility and cost-sharing
amounts.
If you have any questions about the urgent care or
retail health clinic network, please call Customer
Service at 1-800-275-2583.
NaviNet® is a registered trademark of
NaviNet, Inc.