As part of our efforts for Health Care
Reform, AmeriHealth recently launched the 2013 Medical Chart Review Program for
our commercial HMO and PPO and Medicare Advantage HMO benefit plans. The
purpose of this program is to validate our claims coding and submission
processes with the objective of better understanding the health status of
members. We have contracted with Inovalon, Inc. to gather records for these
reviews.
As a commercial health insurer in
Pennsylvania and Delaware, AmeriHealth is required to meet standards set forth
by the U.S. Department of Health and Human Services (HHS). As both a commercial
health insurer and Medicare Advantage Managed Care Organization, AmeriHealth
New Jersey is required to meet standards set forth by the Centers for Medicare
& Medicaid Services and HHS.
If you are selected to participate, an
Inovalon representative will contact you to share details about these reviews
and to determine the most appropriate method of retrieving charts from your
practice.
The methods of retrieving the
charts from your practice include the following options:
- Inovalon can schedule the
most appropriate time for providers for an onsite chart retrieval.
- You can send a secure fax of
the medical records to
1-877-221-0604.
- You can mail copies of
the medical records to the address listed in the letter you may receive.
We appreciate your assistance in this
important program. If you have any questions about this initiative, please call
Customer Service at 1-800-275-2583.