HIPAA (Privacy) Inquiries

Your contact information (* required fields)

* First name:

* Last name:

Address:

Address 2:

City:

State:

ZIP:

* Email address:

* Phone number:

* Member ID:

Your inquiry or comment

What is the nature of your request or comment?

* Message:

To ensure your privacy, all information will be sent via a secure connection. AmeriHealth will not disclose any personal information to outside persons or entities unless we have written consent or unless authorized by law. Please see our Notice of Privacy Practices for more information.