AmeriHealth Medical Policies

Legal Information

medPolicy_AHnav

Medical Policy

> News & Announcements

Policy Bulletins

Radiology Guidelines

News & Announcements

Site Activity

Policy Notifications

About This Site

Search Instructions

News & Announcements

The articles listed below contain current information related to this site, our policies, and important medical information.

Current | Archive


	Coverage and Reimbursement for Aqueous Shunts and Devices for Glaucoma The Company has published its updated coverage position for aqueous shunts and devices for glaucoma. Posted:02/16/2010
	Coverage for AlloMap™ Molecular Expression Test for Heart Transplantation Rejection The Company has published its coverage position on AlloMap™ Molecular Expression Test for Heart Transplantation Rejection. Posted:02/03/2010
	Sleeve Gastrectomy The Company has published its updated position on sleeve gastrectomy. Posted:01/04/2010
	ClaimCheck� upgrade scheduled ClaimCheck, a comprehensive code-auditing tool, was updated to version 8.5.44 on December 18, 2009. Posted:12/18/2009
	Updated Coverage Positions for Human Papillomavirus (HPV) Vaccines Gardasil� and Cervarix� As of October 16, 2009, the US Food and Drug Administration (FDA) has approved two vaccines for the human papillomavirus (HPV): Gardasil� and Cervarix�. As such, the company has published its updated coverage positions. Posted:11/10/2009
	Billing Requirements for Administration of the H1N1 (Swine Flu) The Company has published its billing requirements for the Administration of the H1N1 (Swine Flu). Posted:10/30/2009
	Updated: 00.01.25f PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services The Company has updated claim payment policy 00.01.25f. This article outlines the changes, and the full policy is available in the Policy Bulletin section of this site. Posted:10/30/2009
	Updated Coverage for the Administration of Novel H1N1 (Swine) Flu Vaccine According to the Centers for Disease Control and Prevention, the novel H1N1 (swine) flu vaccine will be made available. As such the Company has published its coverage position for the administration of this vaccine. Posted:10/16/2009
	Updated Coverage of Standard Seasonal Influenza Vaccine for 2009-2010 The 2009-2010 influenza season has arrived. As such the Company has published its updated coverage position on injectable and intranasal seasonal influenza vaccines. Posted:10/16/2009
	Administrative Policies have been archived Three of our administrative policies have been archived and the information can now be found in our About this Site section. Posted:10/12/2009
	Recently Released page renamed Site Activity Our Recently Released page has been renamed Site Activity. It still offers the same features as before, and more! Posted:10/12/2009
	Upcoming changes to self-injectable drug coverage This article from the November 2009 issue of Partners in Health Update highlights changes to the self-injectable drug coverage effective January 1, 2010. Posted:10/09/2009
	Clear Claim Connection Upgrade to Version 4.0 This Friday, October 9, 2009, Clear Claim Connection will be temporarily unavailable to allow for system upgrades. The new version will be available on Saturday, October 10. The upgrade features several changes, so be sure to review this article to learn more. Posted:10/08/2009
	New federal mental health and substance abuse parity mandate effective October 3, 2009 A summary of the new mandate is now available. This article has also been published in the October 2009 Partners in Health Update magazine. Posted:10/01/2009
	ClaimCheck� upgrade ClaimCheck, a comprehensive code-auditing tool, was updated to version 8.5.43.1 on April 20, 2009. Posted:09/22/2009
	Coverage for the Influenza A H1N1 (2009) Real-Time RT-PCR Test The Company has published its coverage position for the Influenza A H1N1 (2009) Real-Time RT-PCR test. Posted:09/16/2009
	Reminder: Mandated coverage for autism spectrum disorders (PA Only) This article from the August 2009 edition of Partners in Health Update provides a summary of the Pennsylvania mandate. Posted:08/07/2009
	American Imaging Management (AIM) Guidelines Updated The Radiology Guidelines section of this site is updated to reflect the 2009 American Imaging Management (AIM) Guidelines that have been approved by the Company. Posted:08/03/2009
	Version effective dates now available on all policy bulletins To promote transparency for our provider and member communities, all of our Medical and Claim Payment Policy bulletins now have corresponding Version Effective Dates that will display at the bottom of the policy. Posted:07/20/2009
	New federal mental health and substance abuse parity mandate A summary of the new mandate is now available. This article has also been published in the July 2009 Partners in Health Update magazine. Posted:07/01/2009
	Access to Rapid H1N1 (Swine-Origin) Influenza A (Flu) Laboratory Tests in the Hospital Outpatient Laboratory Setting The Company has published its updated coverage and reimbursement position for the rapid influenza (Flu) test for H1N1 (swine-origin) influenza A for Health Maintenance Organization (HMO) and HMO Point of Service (POS) product members. Posted:05/11/2009
	Clear Claim Connection service interruption McKesson, the vendor that supplies Clear Claim Connection, has advised that system maintenance to the application is scheduled to occur on May 2, 2009 and will interrupt service from 12:00 am EDT through 1:00 pm EDT. During this time, you will not be able to access this application. Posted:04/20/2009
	Timely submission of maternity patient questionnaires important for early outreach In order to register members into our perinatal program, questionnaires should be mailed right after the first prenatal visit. Posted:01/30/2009
	Reminder: members may receive OB/GYN services without a referral HMO/POS members receive direct access to any network obstetrical/gynecological (OB/GYN) specialist or subspecialist without a referral. Posted:12/18/2008
	Updated reporting requirements for anesthesia services performed by providers in anesthesia specialties for a cancelled or discontinued procedure The Company has updated policy #01.00.02b, Anesthesia Services for a Cancelled or Discontinued Procedure. Posted:12/17/2008
	Pharmacy Policies Move As of October 9, 2008 Pharmacy Policies have moved to a new location Posted:10/09/2008
	Final issue of Coding Guidelines and Policy Update (CGPU) The CGPU newsletter is being discontinued because this Web site provides all the information the CGPU contained and much more. Posted:10/01/2008
	Transition to all-electronic inquiry and submission — Part II Enhancements to the provider interactive voice response (IVR) system will provide you with the ability to submit authorization or precertification requests. This is part of our phased approach toward the electronic authorization mandate project. Posted:09/15/2008
	Use of a robotic surgical system The Company considers the use of a robotic surgical system to be an integral part of the primary surgical procedure. As such, the Company has published its updated reporting requirements and information about separate reimbursement consideration. Posted:08/07/2008
	Policy notifications available online The Policy Notifications section of this Web site is where the Company posts notifications about updates to Medical and Claim Payment Policies prior to the policy's effective date. The notifications will be listed by the intended effective date, and the policy is provided in its entirety. Posted:06/05/2008

Legal Information