Provider Email Sign-Up Form

Complete this brief form to receive the latest news and information of interest to the AmeriHealth New Jersey provider community.

Note: This form should only be completed by participating providers — or their intermediary, (i.e., third-party billing). If you are part of a hospital system, please contact your Provider Partnership Associate for AmeriHealth New Jersey news and information.

 

Email Recipient’s Information

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Office/Company Information

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Third-party billing agency:

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Provider Type

 
Choose provider type as applicable and select the specialty from the drop-down box:
 
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Professional

 

Ancillary

Sign up for the following communications (Check all that apply)

 
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Partners in Health UpdateSM
 
News
 
Medical Director Emails (for participating providers only)
 
Provider Bulletins (Note: Fee schedule information is restricted to contractual notification requirements.)
 

Your company’s firewall and email filters may erroneously block AmeriHealth New Jersey email. To help ensure that your email is not blocked, please forward the following security information to your information services (IS) or information technology (IT) contacts.

To ensure your privacy, all information will be sent via a secure connection. AmeriHealth New Jersey 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.