Changes to AmeriHealth medical and claim payment policies for our commercial
Benefit Programs occur in response to industry, medical, and regulatory
changes. We encourage you to view the Site Activity section of our Medical
Policy Portal to stay up to date with changes to our policies.
The Site Activity section is updated in real time as changes are made to the
medical and claim payment policies. Topics include:
- Notifications
- New Policies
- Updated Policies
- Reissued Policies
- Coding Updates
- Archived Policies
For your convenience, the information provided in Site Activity can be
printed to keep a copy on hand as a reference.
To access the Site Activity section, go to our Medical Policy
Portal and select Accept and Go to Medical Policy Online. From there
select Commercial under Site Activity to view the monthly changes. To
search for active policies, select the Commercial tab from the top of
the page. To access policies from AmeriHealth NaviNet? Plan Central,
select Medical Policy Portal under Provider Tools in the right-hand
column.
Medical codes for services that require
precertification
A list of services that require preapproval/precertification from
AmeriHealth prior to being performed for our members is available for providers
on our Medical Policy Portal. This list, Services that require
precertification, includes the CPT? and HCPCS codes, where
applicable, that correlate with the services and injectable drugs that are
included on the AmeriHealth New Jersey and AmeriHealth Pennsylvania
Preapproval/Precertification Lists.
To access Services that require precertification, visit our Medical Policy
Portal and select Accept and Go to Medical Policy Online. Choose the
Commercial tab from the top of the page, then select New Jersey or
Pennsylvania under Services Requiring Precertification from the
left-hand menu.
Links to Services that require precertification are also available in
the Quick Links section on the right-hand side of this page.
CPT Copyright 2017 American Medical Association. All
rights reserved. CPT? is a registered trademark of the American
Medical Association.
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