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AmeriHealth New Jersey and Meridian Health have collaborated to provide
competitively priced options for individuals and self-funded businesses in
Monmouth and Ocean counties through the new AmeriHealth Advantage plans.
Now with the addition of AmeriHealth Advantage plans, AmeriHealth New Jersey
will be offering "Advantage" Plans in seven New Jersey counties: Camden,
Gloucester, Burlington, Atlantic, Cape May, Monmouth, and Ocean.
Created to be mindful of the member's budget and to provide more choice,
AmeriHealth Advantage plans offer a tiered network option that has lower
copayments and out-of-pocket costs for members who utilize the Tier 1
network.
AmeriHealth Advantage network
Meridian Health is the featured Tier 1 provider in the AmeriHealth Advantage
network, giving members access to Meridian's five hospitals, 400 physicians,
and diverse health care services, including home health services, skilled
nursing and rehabilitation centers, ambulatory care, ambulance services, and
outpatient centers, such as surgery and imaging centers. Physicians who are
part of Meridian Health Partners, Meridian's clinically integrated network,
will work together to improve the quality of care while controlling costs. With
Meridian's more than 100 convenient locations throughout Monmouth and Ocean
counties, members have access to care close to home.
Tier 2 provides members with access to AmeriHealth New Jersey's broader
Local Value Network across the entire state, which offers additional in-network
options.
Requesting referrals and authorizations for AmeriHealth Advantage
members
You may currently have AmeriHealth New Jersey patients who choose to enroll
in AmeriHealth Advantage for 2016. Please be aware that, for these patients,
their network of participating providers will be narrowing as of January 1,
2016. Therefore, if those patients have referrals or authorizations on file
under their current AmeriHealth New Jersey plan, you may need to issue a new
referral or authorization on or after January 1, 2016, to a provider who will
be in-network for AmeriHealth Advantage.
In addition, if you need to request an authorization for a new AmeriHealth
Advantage member for services scheduled in early January, please note that you
will not be able to do so via the NaviNet® web portal until
after January 1, 2016, when your patient's coverage under AmeriHealth Advantage
goes into effect. If you must request an authorization prior to January 1,
2016, you will need to do so by calling 1-888-YOUR-AH1
(1-888-968-7241) and following the prompts for authorizations.
For more information
The new AmeriHealth Advantage plans will be available both on and off the
Individual and SHOP Marketplaces during the 2016 Open Enrollment Period. If you
have a patient who resides in an applicable county and may be interested in
coverage through AmeriHealth Advantage, he or she can get more information by
calling Customer Service at 1-888-YOUR-AH1 (1-888-968-7241).
We encourage you to start having conversations with your AmeriHealth New
Jersey patients about their 2016 plan selection. If you have any questions
about AmeriHealth Advantage, please contact your Provider Partnership
Associate.
NaviNet is a registered trademark of NaviNet, Inc.
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