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We would like to remind you of the urgent care benefit available for most
AmeriHealth Pennsylvania members. This benefit allows AmeriHealth Pennsylvania
members to receive services for urgent medical issues that do not require the
advanced medical services of the emergency room/department (ER) when their
physician is unavailable. Generally, urgent care is categorized as medically
necessary treatment for a sudden illness or accidental injury that requires
prompt medical attention, but is not life-threatening and is not an emergency
medical condition, when a member's primary physician is unavailable.
Eligible members can receive urgent care in the following places:
- Urgent care centers. A health care facility that can provide
medically necessary treatment for a sudden illness or injury that requires
prompt medical attention but is not life-threatening.
- Retail health clinics. A health care facility staffed by certified
nurse practitioners that can treat minor, uncomplicated illnesses and
injuries.
Approved urgent care centers and retail health clinics can be found by using our
Provider Finder tool. For urgent care centers, select
Find Participating Doctors, Hospitals, and Ancillary Providers and enter
your additional search criteria. For approved retail health clinics, choose
Retail Health Clinics from the Find a Provider page. These approved
providers may treat members without a referral or authorization.
You may want to print out a list of the approved urgent care centers and
retail health clinics in your area to keep on hand and share with the staff who
handle after-hours calls. This list may be instrumental in cases when a member
requires urgent medical attention, but your office is closed and ER care is not
necessary.
Note: Not all members are eligible for the urgent care benefit. As
always, continue to check the NaviNet® web portal for member
eligibility and cost-sharing amounts.
If you have any questions about the urgent care or retail health clinic
network, please call Customer Service at 1-800-275-2583.
NaviNet is a registered trademark of NaviNet, Inc.
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