[
As previously communicated, AmeriHealth New Jersey commercial members will
be migrated to the new claims processing platform between September 1, 2015,
and October 1, 2015. During this time, we will be working with you in a dual
claims-processing environment until all of our AmeriHealth New Jersey
membership is migrated to the new platform.
One area of change during the transition is to the Statement of Remittance
(SOR):
- For non-migrated members. For AmeriHealth New Jersey commercial
members who have not yet been migrated to the new platform, providers will
continue to receive the same SOR that they currently receive today.
- For migrated AmeriHealth New Jersey members. For AmeriHealth New
Jersey Medicare Advantage members and commercial members (as they are migrated
to the new platform), providers will no longer receive the current SOR.
Professional providers will receive what is called the Provider Explanation of
Benefits (EOB), and facility providers will receive what is called the Provider
Remittance. The Provider EOB and Provider Remittance have a new look and
format. On the new format for facility claims, services are combined and
displayed on one line.
Detailed guides for the new Provider EOB and Provider Remittance are
available in the Claims Submission and Payments section of the System and
Process Changes site. Terms in the new documents are explained to assist you in
interpreting your payments.
For more information, please visit our System and
Process Changes page on our website. On this site, you will find a
communication archive and frequently asked questions (FAQ) document. If you
still have questions after reviewing the FAQ, email us.
]