We would like to remind you of the urgent care benefit available for most
AmeriHealth members. This benefit allows members to receive services for urgent
medical issues that do not require the advanced medical services of the
emergency room/department (ER) when the 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 care physician is unavailable.
Urgent care is available to members in the following places:
Urgent care centers. Urgent care centers are staffed by board-certified
physicians who can provide medically necessary treatment for a sudden illness
or injury that is not life-threatening.
Retail health clinics. Retail health clinics are staffed by certified family
nurse practitioners trained to diagnose, treat, and write prescriptions for
(when clinically appropriate) common illnesses and medical conditions. Local
supervising physicians are on call during clinic hours of operation to provide
guidance and direction when necessary.
Approved urgent care providers can be found by using our [
]Provider Finder
tool[]. 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.
Please note that 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.
]