If a situation arises when a primary care physician (PCP) or other treating physician initiates termination of its physician-patient relationship and needs to release an AmeriHealth member from his or her practice, there are some important things to remember. The PCP or treating physician must notify both the member and AmeriHealth in writing if terminating a member from his or her practice. To notify AmeriHealth, the physician must contact his or her Network Coordinator, Provider Partnership Associate, or Customer Service, or send correspondence to the appropriate address:

• For an AmeriHealth Pennsylvania member, mail to:
• AmeriHealth
• Attn: Network Services
• 1901 Market Street, 28th Floor
• Philadelphia, PA 19103

• For an AmeriHealth New Jersey member, mail to:
• AmeriHealth New Jersey
• 259 Prospect Plains Road, Building M
• Cranbury, NJ 08512

The physician must also continue treating the member for current medical conditions for 30 days after ending the physician-patient relationship to allow time for the member to select a different treating physician. During this time, we will assist the member in selecting a different PCP or other treating physician. If the member asks the physician or office staff for assistance in selecting a new PCP or other treating physician, he or she should be referred to call Customer Service at 1-800-275-2583 for AmeriHealth Pennsylvania or 1-888-YOUR-AH1 (1-888-968-7241) for AmeriHealth New Jersey. In the event the member is threatening or violent towards the physician or office staff, the member?s access to the office may be terminated immediately.

Non-discrimination

Physicians cannot discriminate against any member on the basis of the member?s coverage under a benefit program, age, sex, race, color, religion, ancestry, national origin, disability, handicap, health status, source or amount of payment, or utilization of medical or mental health services or supplies. Other unlawful reasons for discharging a member, without limitation, include the filing by such member of any complaint, grievance, or legal action against the provider or AmeriHealth. Participating physicians are also prohibited from excluding or closing a practice to certain members as a result of the reimbursement (e.g., closing a practice to capitated HMO patients only). Physicians are also not permitted to terminate their relationship with a member who has complicated or expensive medical needs unless the provider has received written approval from AmeriHealth that there is good cause for such termination and that such termination is in the member?s best interest.

Medical record requests

When a provider initiates termination of the physician-patient relationship with the member, the physician cannot charge members for requests for copies of medical records. The physician must facilitate the sharing of such records among health care providers directly involved with the member?s care.