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As a reminder, AmeriHealth expanded Claim Payment Policy #00.01.47c:
Inpatient Hospital Readmission to include a 6 ? 30 day provision. This policy
went into effect January 15, 2017.
The pre-existing 0 – 5 day provision remained unchanged. Recoveries
for readmissions between 6 – 30 days found to be related, preventable, or
avoidable will be pursued on a post-pay basis.
Note: As per your AmeriHealth Agreement, members may
not be billed for the denied services.
More information
To access this policy, visit our Medical Policy Portal. Select Accept and Go to Medical
Policy Online, then select the Commercial tab from the top of
the page and type the policy name or number in the Search field.
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