endstream endobj startxref Mailing Address 1901 Market Street Philadelphia, PA 19103 Email Complete the Provider Email Sign-Up Form to receive email updates with the latest information, including Partners in Health Update SM. PDF Provider Manual: Administrative Procedures section - AmeriHealth %PDF-1.6 % The Provider Engagement, Analytics & Reporting (PEAR) portal allows access to tools to help manage clinical and financial information and to care for patients. Provider Manuals and Forms Manuals and guides. If you have any questions about these materials or about AmeriHealth Caritas Delaware, call Provider Services at 1-855-707-5818, or contact your Account Executive. The Provider Manual is an easy-to-use reference tool, color-coded, and hyperlinked to provide easy access to the information that providers need most. If you are interested in becoming a contracted behavioral health provider with AmeriHealth Caritas Louisiana, please reach out to your account executive for contracting and credentialing information. The COBRA White Paper was prepared for the group customers of AmeriHealth as a guide to the federal legislation that requires employers to offer continuing health insurance to employees and dependents who would otherwise lose their coverage. Find Providers Precertification Call the number on your patient's ID card or log into iEXCHANGE Provider Services 1-844-352-1706 provrelations@ahatpa.com Claims, benefits, & eligibility Log into PEAR Call the toll-free service phone number on your patient's ID card. Opens a new window. Behavioral health contracting and credentialing - AmeriHealth Caritas Forms - AmeriHealth The Benefits Administrator Guide describes AmeriHealth processes and procedures, such as our eligibility policy, enrollment procedures, premium invoicing, and coordination with Medicare, and includes forms for your use. Provider Claim Inquiry Form This manual will help you avoid delays in the processing of your claims. Providers will be notified via the Provider Explanation of Benefits (EOB), which will include a reason code for the claim return or denial. This manual will help you and your office staff provide services to our members. It looks like your browser does not have JavaScript enabled. Providers may request a print version of theProvider Manualby submitting a request through ouronline order form. You may be trying to access this site from a secured browser on the server. document.write(new Date().getFullYear()) AmeriHealth | AmeriHealth HMO, Inc. Amerihealth Administrators Provider Manual, Honeywell Dp Transmitter Manual, Manual Book Kia Visto, Manual Battery Charging, Canon 4820 Printer Manual, 2000 Rav4 Service Manual, Cj1w-od212 Manual . The manual was developed to assist participating professional providers in conducting business with AmeriHealth in accordance with the Provider Agreement. ICD-10 customerservice@ahatpa.com Provider Manuals and Forms | AmeriHealth Caritas New Hampshire | Providers The future of health care is extremely complex and constantly changing. National Provider Identifier (NPI) The NPI is a unique, ten-digit identifier being issued to all health care providers by the Centers for Medicare & Medicaid Services. Refer to this guide for quick information about services requiring prior authorization and how to submit your request. AmeriHealth Caritas New Hampshire offers these reference materials to our providers. Policies and Guidelines Access medical and pharmacy policies as well as clinical practice guidelines and information about services that require preapproval. TheProvider Manual for Participating Professional Providers (Provider Manual)is part of a provider's Professional Provider Agreement with AmeriHealth HMO, Inc., AmeriHealth Insurance Company of New Jersey, and its affiliates (collectively referred to as "AmeriHealth New Jersey"). TheProvider Manualis an easy-to-use reference tool, color-coded, and hyperlinked to provide easy access to the information that providers need most. Providers may request a print version of theProvider Manualby submitting a request through ouronline order form. Provider manual (published September 2021) (PDF) and revision table (PDF) This manual will help you and your office staff provide services to our members. Claims filing instructions (PDF). Clinical Services Utilization Management, Exclusive National Lab Provider (NJ Only). As a provider, you agree to use this Provider Manual as a reference pertaining to the provision of medical services for members of AmeriHealth Caritas Delaware. We can help you capitalize on it. This Provider Manual was created to assist you and your office staff with providing services to our members, your patients. Learn how to submit claims to AmeriHealth, use EDI services, and access helpful user guides on claims submission and provider appeals and disputes. Provider manual PDF This manual will help you and your office staff provide services to our members. Account Executives (PDF) Behavioral health resources ADHD Provider Guide (PDF) Applied Behavior Analysis (ABA) Manual Basic training 101 PDF AmeriHealth Caritas Delaware Provider Manual Provider Manual - New Jersey 3 AmeriHealth New Jersey Members may choose to select a site other than the PCP's capitated site for these specialty services. AHNJ Provider Manual - AmeriHealth In this section, you'll find items such as member benefit information, credentialing and prior authorization, and how to file a grievance or complaint. Group administrators need to make sure the information on their statement is accurate and that the amount enclosed with their invoice is correct. Provider resources - AmeriHealth Caritas Florida We want to thank our providers for helping to make AmeriHealth Caritas Florida a better health care plan. Innovative Health Care Solutions | AmeriHealth Administrators Use SHIFT+ENTER to open the menu (new window). Health Care Provider Resources | AmeriHealth Administrators Health Care Provider Resources | AmeriHealth Administrators Welcome Providers - AmeriHealth If you prefer, you can print a barcoded cover sheet for a fax submission (found within the portal). View the latest news and information specific to the AmeriHealth-participating provider community, including articles published in Partners in Health UpdateSM and an archive of communications. iEXCHANGE ID is a uniqqgypue account number assigned for your provider and will stay the same for all payers. This content was prepared for the Provider News Center and may not be reproduced in any way without the express written permission of AmeriHealth, AmeriHealth HMO, Inc., AmeriHealth Insurance Company of New Jersey. 633 0 obj <> endobj COBRA Group administrators have the important job of understanding their health insurance programs and assisting their employees with questions and concerns. The Benefits Administrator Guide describes AmeriHealth processes and procedures, such as our eligibility policy, enrollment procedures, premium invoicing, and coordination with Medicare, and includes forms for your use. AmeriHealth Caritas Florida - NaviNet FAQs Provider manuals and guides - AmeriHealth Caritas District of Columbia However, such billing fees must reflect the actual cost of the billing and must not . iEXCHANGE USER MANUAL Logging In A Username, iEXCHANGE ID, and password will need to be created for each user. Providers | Independence Administrators (IBXTPA) Providers | AmeriHealth Caritas Florida You can obtain a copy of a specific policy by calling the clinical services department at 1-888-234-2393. Find an AmeriHealth Administrator Network Provider. Please enable scripts and reload this page. Clinical Services Utilization Management, Exclusive National Lab Provider (NJ Only). Please turn on JavaScript and try again. TheProvider Manualis an easy-to-use reference tool, color-coded, and hyperlinked to provide easy access to the information that providers need most. It looks like your browser does not have JavaScript enabled. TheProvider Manual for Participating Professional Providers (Provider Manual)is part of a provider's Professional Provider Agreement with AmeriHealth HMO, Inc. and its affiliates (collectively referred to as "AmeriHealth"). Thats why weve compiled the following manuals to help group administrators better manage the administration of their organizations AmeriHealth benefit program. (PDF). Each provider office has a designated NaviNet security administrator. Top of Page Please enable scripts and reload this page. Search for Manuals Extension sets your browser default to Yahoo. hb```b``qf`e` The registration form requires an officer or owner of the provider organization to create an account and to identify up to two Organization Administrators to be responsible for end user management. The PEAR portal offers participating providers a single point of entry to multiple digital tools, including PEAR Practice Management, PEAR Comprehensive Visit, and PEAR Analytics & Reporting. Locate your designated AmeriHealth Provider Network Services (PNS) team contact. customerservice@ahatpa.com Contact Clinical Services. administrative Administrative This section gives you and your office staff information on non-clinical aspects of doing business with us. Find important forms, phone numbers, email addresses, mailing addresses, and more. Health Care Providers - Claims Appeal Process | AmeriHealth New Jersey Espaol | / | Tagalog | Franais | Ting Vit | Deutsche | | | | | | | Italiano | Portugus | Kreyl | Jzyk | Polski | | Pennsylvania Deitsch | Mon-Khmer | Din bizaad. Find an AmeriHealth Administrator Network Provider. Find drug formularies, pharmacy policies, information about prior authorizations, and drug programs. Box 7218 Philadelphia, PA 19101 Fax to: 609-662-2480 Appeal arbitration It is updated regularly to provide pertinent information regarding our policies, procedures, and functions. Provider Manual 6 With the implementation of these claim edits, claims submitted with inappropriate coding will be returned or denied. The manual was developed to assist participating professional providers in conducting business with AmeriHealth New Jersey in accordance with the Provider Agreement. ad@ A(G@#PW]A[DJ;\Ec 3%zy `k5W~Hb 3Rf(j]a3aV0\ G7Fzyv1ec.+5dhu-W &. Click the Cancel button if yyyy ypyou incorrectly enter any of the information, or you simply At AmeriHealth Administrators, we have the foresight, technology, and people to help. You may be trying to access this site from a secured browser on the server. Should the Member choose to receive services you have authorized from a Participating Provider or facility other than the PCP's capitated site, you will need to issue a Referral administrative - AmeriHealth You can learn about changes to our systems that affect you, updated referral and eligibility requirements, member cost-sharing, credentialing procedures, as well as our efforts to keep down health care costs. Provider Manuals and Forms - AmeriHealth Caritas De Claims and Billing Information - AmeriHealth Download the Benefits Administrator Guide for Pennsylvania. Find information about billing, electronic and paper claims submission, and other claims and billing requirements. Please consult with your benefits specialist to obtain a COBRA White Paper or attorney for legal or tax advice regarding COBRA. Call Provider Services at 1-800-617-5727 to speak to a representative. 779 0 obj <>stream Manuals and guides. Find info about our standards of care, plus details about a wide array of preventive care and other patient programs. If you have any questions, call Provider Services at 1-833-644-6001, or contact your Provider Services Account Executive. Download the Group Administrator Invoice Guide. %%EOF customerservice@ahatpa.com For all other questions and inquiries, call Customer Service at 1-800-275-2583. This Provider Manual may be changed or updated periodically. Submit your appeal by completing and mailing the appeal form and any additional relevant information in support of your appeal to the following address: AmeriHealth New Jersey Provider Claim Appeals Unit P.O. The Provider Manual for Participating Professional Providers (Provider Manual) is part of your Professional Provider Agreement, as applicable, with AmeriHealth (referred to as "AmeriHealth" or . Find Providers Precertification Call the number on your patient's ID card or log into iEXCHANGE Provider Services 1-844-352-1706 provrelations@ahatpa.com Claims, benefits, & eligibility Log into PEAR Call the toll-free service phone number on your patient's ID card. The Group Administrator Invoice Guide is designed to help make that job easier. Provider Manuals and Forms | AmeriHealth Caritas Ohio 655 0 obj <>/Filter/FlateDecode/ID[<239E50B6BCB5CF45B329F47AC20C19E6>]/Index[633 147]/Info 632 0 R/Length 120/Prev 281850/Root 634 0 R/Size 780/Type/XRef/W[1 3 1]>>stream Registration is required. Download the Benefits Administrator Guide for Pennsylvania. Provider Manual 3 - AmeriHealth coordinates benefits for commercial Members who are Medicare-eligible, have not enrolled in Medicare Parts A or . Find Providers Precertification Call the number on your patient's ID card or log into iEXCHANGE Provider Services 1-844-352-1706 provrelations@ahatpa.com Claims, benefits, & eligibility Log into PEAR Call the toll-free service phone number on your patient's ID card. Passwords must be reset by the user every 30 days. hbbd```b``"^HF"9X" X/X$" Rlkb$mKLL`700C9$0 pX Access various provider forms, and information about network participation and credentialing, and compliance training. It is updated regularly to provide pertinent information regarding our policies, procedures, and functions. AmeriHealth Caritas North Carolina offers these reference materials to our providers for use when treating our members. Provider manual (PDF) Dental provider supplement (PDF) Discharge planning guide (PDF) Minor rights addendum (PDF) Access to care standards Medical (PDF) Behavioral health (PDF) HEDIS Documentation and Coding Guidelines COMPASS Program Guide (PDF) Collecting Social Determinants of Health Data to Address Enrollees' Unmet Needs (PDF) Important information about links to other sites, Language Access Services Access to PEAR is provisioned once to each provider organization, as defined by a single Tax ID or group of Tax IDs. Provider Resources. 1-800-952-3404 Vision Care If you do not know the name of your NaviNet security administrator, ask another NaviNet user in your office to look under "My Profile" to see the name of your security administrator. PDF Administrative Procedures - AmeriHealth The publication is for general informational purposes only and is not to be taken as legal or tax advice. PDF Billing - AmeriHealth Provider Manuals and Forms - AmeriHealth Caritas North Carolina The PEAR portal offers participating providers a single point of entry to multiple digital tools, including PEAR Practice Management, PEAR Comprehensive Visit, and PEAR Analytics & Reporting. For employers, producers, health insurers, payers, health care providers, and plan members, we can do more than help you navigate change. This person can assist you in identifying your ID and resetting your password. Log in Questions? Amerihealth Administrators Provider Manual Use SHIFT+ENTER to open the menu (new window). Your feedback, questions, and concerns are always welcome. PDF Provider Manual For Participating Professional Providers - AmeriHealth AmeriHealth Administrators, an independent company, performs medical management services on behalf of Independence Administrators. 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