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Provider appeals form available online

January 29, 2016

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Our provider appeals form gives you the ability to email or fax us your appeal requests for AmeriHealth New Jersey members. With this form, the process should be quicker, as you no longer have to mail in the application – saving time, cost, and processing.

Download and complete the Health Care Provider Application to Appeal a Claims Determination form*. You can either email it or fax it to 609-662-2610. While providers may continue to mail in the application, we strongly encourage you to use the email or fax option.

Please contact your Provider Partnership Associate if you have any questions.

*This information does not apply to Magellan Healthcare, Inc. (Magellan) provider appeals related to denied behavioral health authorizations. Magellan provider appeals related to authorizations should be directed to Magellan at 1-800-809-9954.

Magellan Healthcare, Inc. manages mental health and substance abuse benefits for most AmeriHealth members.

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