Changes to AmeriHealth medical and claim payment policies for our commercial Benefit Programs occur in response to industry, medical, and regulatory changes. We encourage you to view the Site Activity section of our Medical Policy Portal to stay up to date with changes to our policies.
The Site Activity section is updated in real time as changes are made to the medical and claim payment policies. Topics include:
- Notifications
- New Policies
- Updated Policies
- Reissued Policies
- Coding Updates
- Archived Policies
For your convenience, the information provided in Site Activity can be printed to keep a copy on hand as a reference.
To access the Site Activity section, go to our Medical Policy Portal and select Accept and Go to Medical Policy Online. From there select Commercial under Site Activity to view the monthly changes. To search for active policies, select the Commercial tab from the top of the page. To access policies from AmeriHealth NaviNet® Plan Central, select Medical Policy Portal under Provider Tools in the right-hand column.
Medical codes for services that require precertification
A list of services that require preapproval/precertification from AmeriHealth prior to being performed for our members is available for providers on our Medical Policy Portal. This list, Services that require precertification, includes the CPT® and HCPCS codes, where applicable, that correlate with the services and injectable drugs that are included on the AmeriHealth New Jersey and AmeriHealth Pennsylvania Preapproval/Precertification Lists.
To access Services that require precertification, visit our Medical Policy Portal and select Accept and Go to Medical Policy Online. Choose the Commercial tab from the top of the page, then select New Jersey or Pennsylvania under Services Requiring Precertification from the left-hand menu.
Links to Services that require precertification have also been added to the Quick Links section on the right-hand side of this page.
Note: As of January 1, 2017, AmeriHealth New Jersey no longer offers Medicare Advantage products. The information related to Medicare Advantage products on the Medical Policy Portal remains available as a reference for services rendered through December 31, 2016.
CPT Copyright 2016 American Medical Association. All rights reserved. CPT® is a registered trademark of the American Medical Association.
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