Copayment Reimbursements - AmeriHealth
What copays can I submit to AmeriHealth for reimbursement?
POS $5 Copay: Submit your doctors’ office receipts to AmeriHealth for your copayment to be applied to your deductible. Once your deductible is met you will be reimbursed 70% of your copay amount.
POS $10 Copay: Submit your doctors’ office and prescription receipts for your copayments to be applied to your deductible. Once your deductible is met you will be reimbursed 80% of your copay amount.
We ask that members use the following guidelines to insure prompt processing of the claims:
AmeriHealth requires copayment reimbursement requests be submitted on a quarterly basis. Reimbursement for copayments with a Date of Service more than 1 year prior to the submission of the claim form will be denied. Please see the Special Note below for 1st and 2nd quarter 2009 receipts.
1) Complete a Claim Form
2) Photocopy as many of the copay receipts as possible onto an 8.5x11 sheet of paper, being sure that all necessary info is showing clearly for each receipt (i.e. provider name, provider address, complete drug information or medical procedure code, and the date of service, along with amount paid by member clearly indicated or circled). AmeriHealth does not need the original receipts. Photocopies are fine.
3) Members should clearly mark their respective AmeriHealth Member ID # on each copay receipt.
The claim form, along with the receipts, can be sent to the mailing address below-
AmeriHealth Processing Services
P.O. Box 41574
Philadelphia, PA 19010-1574
If you have any questions, please call 1-800-422-2457.
This process only applies to the submission of copay receipts (office visit copays or Rx copays).
SPECIAL NOTE FOR 1st AND 2nd QUARTER 2009 RECEIPTS:
Members may submit 1st and 2nd Quarter 2009 receipts for reimbursement up to July, 1, 2010. After July 1, 2010, AmeriHealth will no longer accept any copayment reimbursement past one year.
For any member that has a claim that falls within the extended filing timeline and has not yet submitted the copayment receipts to AmeriHealth, should send their claims to the below address:
AmeriHealth Insurance Company
Attn: Phil Woodard
1500 Spring Garden Street
Phila., PA 19130-4009
This address is only to be used for the submissions of 1st and 2nd quarter 2009 receipts up to July 1, 2010. Any member who is submitting claims within a one year period should continue to submit the claims through the normal process.
Any member that has had claims denied due to timely filing should contact Gallagher Benefit Services. Click here for Contact information.
Prescription Claim Detail- Members may download a Claim Detail form from the Benecard site to view prescription claims that have been processed for themselves and their dependents. This Claim Detail can then be submitted in lieu of the actual prescription receipts for co-pay reimbursements.
To view an example of this Claim Detail, please click here.
For information on accessing and navigating the Benecard site, please click here.
"Elaine's Tip" - When submitting copay reimbursements, group in packets approximating $200 for each member using one claim form for each packet. When you receive your Explanation of Benefits (EOB) form from AmeriHealth it will be much easier to verify you received the correct reimbursement. |
