Changes to AmeriHealth medical and claim payment policies for our commercial Benefit Programs occur in response to industry, medical, and regulatory changes. We encourage you to view the Site Activity section of our Medical Policy Portal to stay up to date with changes to our policies.
The Site Activity section is updated in real time as changes are made to the medical and claim payment policies. Topics include:
- Notifications
- New Policies
- Updated Policies
- Reissued Policies
- Coding Updates
- Archived Policies
For your convenience, the information provided in Site Activity can be printed to keep a copy on hand as a reference.
To access the Site Activity section, visit our Medical Policy Portal and select Accept and Go to Medical Policy Online. From there select Site Activity to view the monthly changes. To search for active policies, select the Commercial Policies tab from the top of the page. To access policies from the NaviNet® web portal (NaviNet Open), go to AmeriHealth NaviNet Open Plan Central, select Medical Policy Portal under Quick Links in the right-hand column.
Medical codes for services that require precertification
A list of services that require preapproval/precertification from AmeriHealth prior to being performed for our members is available for providers on our Medical Policy Portal. This list, Services that require precertification, includes the CPT® and HCPCS codes, where applicable, that correlate with the services and injectable drugs that are included on the AmeriHealth New Jersey and AmeriHealth Pennsylvania Preapproval/Precertification Lists.
To access Services that require precertification, visit our Medical Policy Portal. Links to Services that require precertification can also be accessed from the Quick Links section on the right-hand side of this page.
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