Page 8 - Amerihealth New Jersey - Small Group - 2021 Benefits at a Glance

Optimizing the value of health care
As stewards of your dollar we regularly review our our programs processes and policies We use industry benchmarks and and best practice standards to identify and and address outliers in health care
costs and and utilization Once we we identify opportunities for improvement we we embed them into our utilization management and claim payment policies Driving value in in medical management We have optimized our medical management savings to ensure members receive high-quality health care
in in the safest setting As a a a a a a result we are:
• Driving evidence-based care
• Reducing the number of unnecessary procedures and related costs from
potential complications
• Increasing member access to services in in in the most cost-effective setting Network Management and Reimbursement Administration
Utilization Management Payment Optimization Medical/Pharmacy Policy
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