The Hospital Manual for Participating Hospitals, Ancillary Facilities, and Ancillary Providers (Hospital Manual) is part of a Hospital, Ancillary Facility, or Ancillary Provider Agreement (Agreement) with AmeriHealth HMO, Inc., AmeriHealth Insurance Company of New Jersey, and its affiliates (collectively referred to as "AmeriHealth New Jersey").
The manual was developed to assist participating hospitals, ancillary facilities, and ancillary providers in conducting business with AmeriHealth New Jersey in accordance with the Agreement.
The Hospital Manual is an easy-to-use reference tool, color-coded, and hyperlinked to provide easy access to the information that providers need most. It is updated regularly to provide pertinent information regarding our policies, procedures, and functions.
Hospital Manual (NJ)
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Introduction (December 2025)
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General Information (May 2023)
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Administrative Procedures (December 2025)
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Fraud, Waste, and Abuse (November 2025)
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Medical Policy & Claim Payment Policy (June 2021)
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Clinical Services – Utilization Management (April 2026)
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Quality Management (December 2025)
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Behavioral Health (March 2026)
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Billing & Reimbursement for Hospital Services (March 2026)
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Billing & Reimbursement for Ancillary Services (November 2025)
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Disclaimer Information (June 2021)