The state of New Jersey has issued a mandate for a new reimbursement method for maternity services. Effective January 5, 2012, AmeriHealth New Jersey will offer obstetric providers licensed in New Jersey the option to elect a new installment reimbursement method for maternity services.

Currently, obstetric providers receive reimbursement from health insurers for maternity services rendered after delivery of a baby rather than during the term of the pregnancy. This is known as the global reimbursement method. The State mandate allows obstetric providers to elect a new installment reimbursement method where they will be reimbursed in three installments for maternity services during the term of the covered patient?s pregnancy.

The annual reimbursement election period for 2012 will begin January 5, 2012, and will conclude December 31, 2012. The annual reimbursement election period for each year after 2012 will begin January 1 and will conclude January 31.

Beginning January 5, 2012, your practice can elect the installment reimbursement method through the NaviNet? web portal. To do so, select Provider Change Form from the Plan Transactions menu, select your provider office location from the drop-down menu, and then select Choose Maternity Claims Payment Option from the Change Form Options drop-down menu. If your practice is not NaviNet-enabled, you can contact your Network Coordinator to initiate your election. Each practice will receive a confirmation upon processing of a newly elected reimbursement method.

If an election change is not requested during the reimbursement election period, the practice?s reimbursement payment method will remain the same as it was during the previous election period.

If you have any questions about the reimbursement methods or elections for maternity services, please call Customer Service at 1-800-275-2583 or contact your Network Coordinator.

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