As part of our transition to our next generation platform, AmeriHealth HMO, Inc., AmeriHealth Insurance Company of New Jersey, and AmeriHealth Administrators (collectively, AmeriHealth) are implementing changes to streamline payments to providers for medical claims by offering more efficient electronic methods and reducing the need to mail paper checks.
AmeriHealth will transition from the vendor we currently use to issue medical claim payments to PNC Bank's Claim Payments & Remittances (CPR) service, powered by ECHO Health. The transition will include medical claim payments and remittances and capitation payments, including 835 transactions and electronic funds transfer (EFT).
Key events:
- Base capitation payments: All base capitation payments will be processed by CPR starting
January 2024, for all AmeriHealth members. Payment rosters will continue to be accessed via the Analytics & Reporting application on the PEAR portal. Additional information will be shared as we approach January. - Claim payments: Starting January 2024, medical claim payments and remittances for New Jersey AmeriHealth Medicare members will be sent via CPR. Payments will continue to be processed by our current vendor until the member's plan is moved to the new platform. As a result, you may receive multiple payments within a given payment cycle (e.g., weekly).
What do I need to do to prepare?
- Existing account with CPR/ECHO. Some providers may already use CPR/ECHO for other health insurer payers. Additional information about your account, EFT, or 835 updates will be provided directly by ECHO in November.
If you are currently set up for EFT payments from AmeriHealth, your EFT payment instructions and ERA delivery preferences will be transferred to CPR automatically.
- New to CPR/ECHO. If you are new to CPR/ECHO, you will receive an additional communication in November with information from ECHO that outlines the options available to receive payments, including EFT, virtual credit card, electronic check, or paper check.
Important: If you are not paid via EFT or there is no payment preference selected, you will receive payment via a Virtual Credit Card. Please note that normal transaction fees apply and are based on your merchant-acquirer relationship.
Learn more
If you have questions on this transition, please contact Provider Services at 1-888-YOUR-AH1 (1-888-
968-7241) in New Jersey or 1-800-275-2583 in Pennsylvania. For questions on updating your payment preference, please contact ECHO Health at 1-800-813-9861.
We encourage you to frequently visit our dedicated Platform Transition page to stay up to date on the upcoming changes.