Peer-to-peer request form
If this is an urgent request, please call the AmeriHealth New Jersey Medical Director’s Office at 1-877-585-5731 and press 2. For all out-of-area requests, please call 1-888-YOUR-AH1 (1-888-968-7241) and press 1. All non-urgent calls will be returned within 24 hours.
Please complete all information requested on this form.
Please note that for Medicare Advantage members, a peer-to-peer discussion may not result in a change in the initial not certified (denial) coverage for any type of pre-service or skilled nursing facility extension determinations. The peer-to-peer discussion only affords an informal opportunity for the requesting physician to receive an explanation of the clinical basis for the adverse coverage determination. The AmeriHealth New Jersey Medical Director will verbally notify the physician of first-level standard or expedited appeal rights. The provider is then directed to Member Services to begin a standard or expedited appeal as appropriate.
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.