Claims and Billing Information
X12 Gateway Transition
Get information about the upcoming transition to the Highmark Gateway.
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.
Prepare for the next generation of International Classification of Diseases (ICD-10).
Electronic Data Interchange (EDI Services)
Electronic Data Interchange Services is your electronic way to submit information. Providers can access important documents and data online, such as HIPAA Companion Guides, sample transactions, and regulation updates.
Claims Requirements and Communications
Access important news, information, and resources related to the billing and submission of AmeriHealth claims.
Claims Submission Addresses
Access all claims-related mailing addresses.
Claims Requiring Submission of Clinical Information
AmeriHealth may routinely require submission of clinical information in connection with adjudication of claims, before or after processing of claims for unlisted codes, claims to which Modifier 22 is appended, and other limited categories of claims.
Provider Claim Appeals Process (NJ Only)
Get details on the state mandated requirements for initiating an appeal or arbitration request.
Chiropractic Billing Guide
Access the 2006 Chiropractic Billing Guide for clear, helpful information about billing requirements.
Clear Claim ConnectionTM and Significant Edits Disclosure Report
Clear Claim ConnectionTM is a web-based reference tool designed to mirror how Claim Check® evaluates code combinations during the auditing of professional claims. The Significant Edits Disclosure Report is a searchable list of ClaimCheck® Significant Edits.
Kentucky Family Planning Claim Search
Kentucky providers are able to get a status on family planning claims and information regarding members of the Passport Health System.