In order to efficiently conduct admission reviews of inpatient emergency admissions, clinical information regarding the member's medical condition and treatment is required. Clinical information should be provided within a short time frame after notification of emergency admissions. Ideally, this information should be sent to AmeriHealth within two business days. Failure to provide the required information within 30 days of notification of admission will result in case closure with a denial due to lack of information.

Should the hospital receive a denial due to lack of information, the request for an admission review can be resubmitted when the clinical information is available. To submit the new request, call 1-888-YOUR-AH1 (1-888-968-7241) for AmeriHealth New Jersey or 1-800-275-2583 for AmeriHealth Pennsylvania and follow the prompts for authorizations. Please note that the submission of complete medical records is not required and could delay the admission review process.

For questions regarding this information, please contact Alfreda Earp, administrative assistant, at 215-241-3065, and she will direct your inquiry to the appropriate area.