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Concierge medicine, also referred to as retainer medicine, is a
relationship between a patient and a physician in which the patient pays an
annual fee or retainer. Please be advised that the practice of charging
AmeriHealth members a mandatory annual payment violates the terms of your
AmeriHealth Professional Provider Agreement ("Agreement").
Physicians who participate with AmeriHealth are required to comply with the
terms and conditions of their Agreement, which requires participating providers
to accept payment from AmeriHealth as payment in full for Covered Services.
Covered Services are considered to include:
- well-patient visits
- emergency telephone consultation available 24 hours a day, seven days a
week
- treatment of acute conditions
- coordination of medically necessary care
- referrals to appropriate specialists for treatment
In addition, extending the length of a visit, coordinating medically necessary
care, and/or providing wellness-type services are integral to the provision of
Covered Services and are consistent with a standard of care AmeriHealth expects
from participating providers.
Participating providers are required to provide Covered Services during
normal business hours, but they must also be available to AmeriHealth members
by telephone 24 hours a day, seven days a week, for consultation on medical
concerns and emergencies.
Please be advised that AmeriHealth-participating providers who elect to open
a concierge practice that requires members to pay a designated fee for Covered
Services to remain in their practice are in violation of their Agreement and
are subject to termination from the AmeriHealth network.
If you have any questions, please contact your Network Coordinator or
Provider Partnership Associate.
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