As a reminder, AmeriHealth New Jersey is making coding updates to our claim payment policy on telemedicine services. Claim Payment Policy #00.10.42a: Telemedicine and Telehealth Services was posted as a Notification on November 30, 2018, and will go into effect January 1, 2019.
This policy is based on the State of New Jersey telemedicine law (P.L. 2017, c117) requiring insurance carriers to cover telemedicine services which went into effect July 21, 2017.
Important information on collecting member copayments for telemedicine services
In accordance with the law, insurers may not charge a higher deductible, copayment, or coinsurance for a health care service, delivered through telemedicine or telehealth, than the amount that is applicable to an in-person consultation.
Effective January 1, 2019, AmeriHealth New Jersey will be reducing the member copayment for telemedicine services to 50 percent of what the copayment amount would be for an in-office visit.
Note: We are in the process of coding all of our systems to reflect this change for telemedicine services. Until then, providers will not be able to see that the copayment for telemedicine services is 50 percent of the in-office amount through the NaviNet® web portal or on the 271 EDI electronic return. We will provide more information when this coding change is operational in our systems.
More information
To view the Notification for this policy, visit our Medical Policy Portal. Select Accept and Go to Medical Policy Online. Then select Active Notifications.
If you have additional questions, please contact Provider Services at 1-888-YOUR-AH1.
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