Provider Notifications

A newly activated feature allows providers to bypass the InterQual review process when completing prior authorization submissions.

Highlights include: Medical Assistance renewals are coming — important information to share with your patients regarding their health care coverage; Inpatient claims and Medicare Part B billing recommendations; Members’ and Participants’ rights and responsibilities; and more.

Please review these details regarding the process for submitting dental benefit limit exception (BLE) requests.

Effective May 1, 2023, members currently receiving more than the quantity limit for certain products will require prior authorization. This change does not apply to members for whom it is not medically advisable to change therapy.

Effective January 2023, Labcorp is another choice for your AmeriHealth Caritas Pennsylvania patients requiring outpatient lab tests or processing of lab specimens.