Information about the AmeriHealth Quality Management Program is accessible on
the
AmeriHealth Quality
Management Program section of our website. AmeriHealth is dedicated to
maintaining the highest standard of care and service for our members,
providers, and the communities we serve. The following information about our
Quality Management Program is available on our website to promote our standards
of care:
Quality Management Program. The description of the AmeriHealth Quality
Management Program includes program goals, objectives, and activities to
improve clinical, network, and service quality.
Member rights and responsibilities. All AmeriHealth members have
defined rights and responsibilities.
Medical record-keeping standards. Well-maintained medical records are
critical to facilitate communication, continuity, coordination, and an
effective plan of care. Accordingly, AmeriHealth standards require that medical
records are maintained in a manner that is current, detailed, and organized as
required by applicable regulatory requirements.
Access and availability standards. AmeriHealth standards ensure that
our managed care networks are adequate to meet the needs of our members with
respect to location and appointment accessibility for primary and specialty
care as well as urgent and emergency care in accordance with applicable
regulatory requirements.
Privacy and confidentiality. AmeriHealth, our contractors, and our
affiliates are required to protect the privacy and confidentiality of our
members' personal and health information in accordance with state and federal
regulatory requirements.
Please review the standards listed in this article to ensure that your office
maintains the required access, documentation, and quality care expected of our
network providers. For more information about our Quality Management Program
and our progress in meeting program goals, please visit our website or contact
Customer Service at
1-800-275-2583 for providers in
Pennsylvania and Delaware or
1-888-YOUR-AH1 (
1-888-968-7241) for providers in New Jersey. Members can
request the same information by calling Customer Service.
Note: Information about our Quality Management Program and these
standards can also be found in the
Provider Manual for Participating
Professional Providers and the
Hospital Manual for Participating
Hospitals, Ancillary Facilities, and Ancillary Providers, which are
available through the NaviNet
® web portal. Paper copies of the
manuals can be ordered by submitting an
online request or by
calling the Provider Supply Line at
1-800-858-4728.
NaviNet® is a registered trademark of
NaviNet, Inc.