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Upcoming change to the outpatient laboratory provider network for AmeriHealth Pennsylvania members

July 14, 2017


Attention! An update has been made to this page.


A letter was recently mailed to notify affected providers of an upcoming change to the AmeriHealth HMO, Inc. (AmeriHealth) outpatient laboratory provider network. The change and impact to providers are outlined below.

Outpatient laboratory provider network change

Effective October 1, 2017, AmeriHealth will be ending its contract with Quest Diagnostics (Quest), and Quest will therefore be considered out-of-network for AmeriHealth Pennsylvania members.

This change applies to all AmeriHealth HMO and POS members, including individual and group members.

For primary care physicians

Updating your capitated outpatient laboratory provider

As communicated in the letter, those providers who are capitated to Quest or listed as ?unassigned? for outpatient laboratory services for AmeriHealth Pennsylvania members will need to select another in-network capitated outpatient laboratory provider.

For ease of transition, AmeriHealth will automatically assign Laboratory Corporation of America® Holdings (LabCorp) as your capitated outpatient laboratory provider for AmeriHealth Pennsylvania members effective October 1, 2017, unless you select another participating outpatient laboratory provider. If you have questions about your assignment or you would like to change LabCorp as your capitated provider, please send a request by email to ahPracticeUpdates@amer ihealth.com or by fax to 215-761-9560.

Requests to update your capitated outpatient laboratory provider require 30 days advance written notice to AmeriHealth for processing. Your request will be completed on the first of the month following the 30-day period after your request is received by AmeriHealth (e.g., a request submitted on July 30th would go into effect September 1st). Please be sure to include a contact person?s name, phone number, fax number, and email address in your email or fax request. We will contact you within three business days if there are any questions about your request. If you are not contacted, your request will be completed within the previously stated time frame.

Use an in-network outpatient laboratory provider

As a reminder, your Professional Provider Agreement with AmeriHealth requires you to direct members and/or their lab specimens to an in-network outpatient laboratory provider, except in an emergency, as otherwise described in the applicable Benefit Program Requirements, or as otherwise required by law.


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