Update on our transition to a new platform

As we continue our transition to our new operating platform, we want to provide you with an update on our progress and a summary of key changes to date.

Beginning July 2024, additional membership will transition to the new platform upon their renewal date. This will be a rolling transition, with new members moving each month. New ID cards will be distributed each month for members who are transitioned. It is important to ask members for a copy of the member’s latest ID card at every visit to ensure eligibility and proper claims processing. Keep an eye out for the upcoming new member ID card reminder article for tips on claims processing and authorizations.

Key changes implemented since January 1, 2024:

  • Provider payments. On January 1, 2024, we transitioned medical claim payments and remittances and capitation payments to PNC Bank's Claim Payments & Remittances (CPR) service, powered by ECHO Health. Therefore, you will see an increase in the new Explanation of Provider Payment (EPP) for claims processed on the new platform after July 1, 2024, as more members transition.

    You can view your EPP on ECHO Health's provider portal.

  • Taxonomy code requirements. As of January 1, 2024, we require the use of taxonomy codes to ensure proper claims processing and payment. This allows for the accurate application of specialty-driven policies and matching of the provider's agreement(s) with AmeriHealth.

    If the proper taxonomy code is not present in the required fields/segments, your claim will be denied, and you will be required to submit a corrected claim. Please review the requirements outlined here and the claim submission guides on our website.

    It's important that you work with your billing vendors and/or billing software vendors to ensure these requirements have been implemented accordingly.

Stay informed

To stay up to date on the transition, please review our on-demand training sessions and FAQ under Training and Resources on our dedicated Platform Transition page.