On April 1, 2012, AmeriHealth will
introduce a new urgent care benefit designed to provide members with a lower
cost alternative to emergency rooms, when appropriate. This new benefit will
allow members to receive services for urgent medical issues when they cannot
access their physician?s office but do not require the advanced medical
services of an emergency department.
Generally, urgent care is considered
medically necessary treatment for an unexpected illness or accidental injury
that is not life- or limb-threatening, where immediate services are required in
order to prevent a serious deterioration in the member?s health.
In order to be recognized as an
approved AmeriHealth urgent care provider, centers must
meet specific criteria (including network need) and be credentialed and
contracted as an urgent care center by AmeriHealth. Approved providers
will be identified in the AmeriHealth provider directory as such and will be
eligible to treat members without the need for a referral or authorization.
Look for future communications
concerning details surrounding the new urgent care member benefit. If you have
any questions about this new urgent care network, please call 1-800-275-2583.