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Network Selection Criteria

Network Selection Criteria for Doctors

AmeriHealth Pennsylvania has a robust credentialing program and monitors the overall ongoing quality of its broad network through its quality and patient safety programs. AmeriHealth Pennsylvania does not use a specific subset of quality, member experience, or cost-related measures to select individual practitioners for participation in the AmeriHealth Pennsylvania networks. AmeriHealth Pennsylvania evaluates its networks and takes into consideration the geographic distribution of healthcare providers to ensure that AmeriHealth Pennsylvania members have access to participating providers within federal and state availability and accessibility standards.

The medical practitioner specialty types available in these AmeriHealth Pennsylvania networks include but are not limited to, Allergy/Immunology, Cardiology, Dermatology, Endocrinology, Family Practice, Gastroenterology, General Surgery, Neurology, Neurosurgery, Obstetrics & Gynecology, Oncology/Radiation, Ophthalmology, Orthopedic Surgery, ENT/Otolaryngology, Urology, Chiropractor, Internal Medicine, Infectious Disease, Nephrology, Pediatrics, Physiatry/Rehabilitative, Plastic Surgery, Pulmonary, Rheumatology.

AmeriHealth Pennsylvania delegates the contracting and management of the behavioral health network to Magellan Behavioral Health. AmeriHealth Pennsylvania oversees this delegated arrangement according to all regulatory and accreditation requirements. Specialty types available in these behavioral health networks include but are not limited to, Psychiatry, Clinical Psychology, Licensed Clinical Social Worker, Licensed Counselor (including Licensed Professional Clinical Counselor, and Licensed Marriage and Family Therapist).

Network Selection Criteria for Hospitals

AmeriHealth Pennsylvania has a robust credentialing program and monitors the overall ongoing quality of its broad network through its quality and patient safety programs. AmeriHealth Pennsylvania does not use a specific subset of quality, member experience, or cost-related measures to select hospitals for participation in the AmeriHealth Pennsylvania networks. AmeriHealth Pennsylvania evaluates its networks and takes into consideration the geographic distribution of hospitals to ensure that AmeriHealth Pennsylvania members have access to participating hospitals within federal and state availability and accessibility standards.