Concierge medicine, also referred to as retainer medicine, is a relationship between a patient and a physician in which the patient pays an annual fee or retainer. Please be advised that the practice of charging AmeriHealth members a mandatory annual payment violates the terms of your AmeriHealth Professional Provider Agreement (Agreement).

Physicians who participate with AmeriHealth are required to comply with the terms and conditions of their Agreement, which requires participating providers to accept payment from AmeriHealth as payment in full for Covered Services. Covered Services are considered to include:

• well-patient visits
• emergency telephone consultation available 24 hours a day, seven days a week
• treatment of acute conditions
• coordination of medically necessary care
• referrals to appropriate specialists for treatment

In addition, extending the length of a visit, coordinating medically necessary care, and/or providing wellness-type services are integral to the provision of Covered Services and are consistent with a standard of care AmeriHealth expects from participating providers.

Participating providers are required to provide Covered Services during normal business hours, but they must also be available to AmeriHealth members by telephone 24 hours a day, seven days a week, for consultation on medical concerns and emergencies.

Please be advised that AmeriHealth-participating providers who elect to open a concierge practice that requires members to pay a designated fee for Covered Services to remain in their practice are in violation of their Agreement and are subject to termination from the AmeriHealth network.

If you have any questions, please contact your Provider Partnership Associate or Network Coordinator.