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Office of Managed Care Operations
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Quick Reference Guide |
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Telephone Guide |
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Claims Address |
Facility/Provider Inpatient # 010000947-00
Outpatient # 010000947-02
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ELECTIVE |
REQUIREMENTS |
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INPATIENT ADMISSION |
Authorization Required by Physician or Hospital, 7 days prior to procedure |
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SAME DAY SURGERY |
Authorization Required by Physician or Hospital, 7 days prior to procedure |
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OUT PATIENT PROCEDURE |
Authorization required by Physician or Hospital, 7 days prior to procedure |
NOTE: Admitting Physician must call to obtain authorization @ 1-888-362-3368 (precertification). Hospital Admitting Department must call Americhoice prior to admission or surgery to make sure admission or surgery has been authorized.
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EMERGENCY ROOM VISIT |
No Authorization or Notification Required |
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EMERGENCY ADMISSION |
Authorization Required (24-hr notification required by PCP or Hospital) |
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DIRECT ADMISSION |
Authorization Required (24-hr notification required by PCP or Hospital) |
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MENTAL HEALTH/ADMISSION SUBSTANCE ABUSE |
Authorization Required (24-hr notification required by Hospital) for enrollees of the Division of Developmental Disabilities only. (See note below) |
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NON EMERGENCY MENTAL HEALTH & SUBSTANCE ABUSE |
Authorization Required (24-hr notification required by Hospital) for enrollees of the Division of Developmental Disabilities only. (See note below) |
Note: Behavioral Health Services (mental health and substance abuse) are covered by Americhoice for enrollees of the Division of Developmental Disabilities only. All other members receive these servies through the fee or service State Medicaid program.
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REFERRAL REQUIRED – OUTPATIENT |
PRE AUTHORIZATION REQUIRED- OUTPATIENT |
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Note: Physical, occupational and speeech therapies are covered for all members under the traditional State Medicaid Program.
| Americhoice Provider Representative, Jennifer Wallace | (973) 297-5664 |
| Americhoice Provider Relations | (973) 297-5544 |
| Americhoice Precert Department/Claims | 1-888-362-3368 |
| Vision Care/ Block Vision Member Services | 1-800-428-8789 |
| Vision Care/ Block Vision Provider Services | 1-800-243-1401 |
| Vision Care/ Block Vision Eligibility Verification | 1-800-879-6901 |
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(all information subject to change without notice) |
Last Reviewed: June 2002
All contents copyright © 1997-8
UMDNJ. All rights reserved
All information within this site subject to change without notice.
University Hospital
150 Bergen Street
Newark, NJ 07103 USA
(973) 972 - 4300