Effective April 1, 2013, the AmeriHealth Care Management and Coordination (CMC) department is changing the process for the review of emergency admissions following notification through the NaviNet^? web portal. CMC will no longer remind hospitals to provide clinical information to complete the medical necessity review for authorization and payment. Hospitals will need to provide the clinical information to CMC within two business days of notice to complete authorization. Failure to provide clinical information to CMC in a timely fashion may delay reimbursement. Upon completing the notice of the emergency admission, hospitals will receive a modified NaviNet message as a reminder to submit clinical information to complete authorizations. Hospitals may also refer to NaviNet to confirm the status of any authorization. To do so, select ER Admission Notification from the Authorizations option in the Plan Transactions menu. If you have any questions about this change in procedure, please contact Marianne Brown, Manager of Utilization Management at 215-241-4655.

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