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Our Quality Management Program promotes quality of care and service

December 2, 2013

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.

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