As previously communicated, we are in the process of transitioning AmeriHealth
Pennsylvania members to a new claims processing platform, which will offer
greater capabilities, increased flexibility in benefit design, and enhanced
functionalities for an improved overall customer experience.
During this transition, we will be working with you in a dual claims-processing
environment until all of our AmeriHealth Pennsylvania members are on the new
platform. In other words, as AmeriHealth Pennsylvania members are migrated,
their claims will be processed on the new platform; however, we will continue
to process claims on the current AmeriHealth platform for AmeriHealth New
Jersey and Delaware members and for AmeriHealth Pennsylvania members who have
not yet been migrated.
You will see changes in member ID numbers for AmeriHealth Pennsylvania members.
As AmeriHealth Pennsylvania members are migrated to the new platform, they will
be issued a new ID card and assigned a new member ID number. Both the
subscriber and all dependents will share the same member ID number —
dependents will no longer have a unique suffix. You must submit claims using
this new ID number. Please discontinue use of any outdated member ID numbers.
It is imperative that all providers ask members for their current ID card at
each visit and make a copy for your records, as all AmeriHealth Pennsylvania
member ID numbers eventually will be reassigned through 2015. In addition, be
sure to verify member eligibility and benefits using the
NaviNet
® web portal.
Adhering to these claims submission requirements will help to make the claims
submission process smooth during this time of transition. If you submit a claim
that uses outdated information, your claim may not be paid.
For more information, please visit our
Upcoming System and
Process Changes web page. 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 at
providercommunications@amer
ihealth.com.
NaviNet® is a registered trademark of
NaviNet, Inc.
PLEASE NOTE: To ensure proper claims
processing, be sure to submit claims using your NPI and taxonomy code.