Complaints

This profile includes complaints for AmeriHealth Insurance Company of New Jersey's headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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AmeriHealth Insurance Company of New Jersey has 3 locations, listed below.

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• 

  AmeriHealth Insurance Company of New Jersey

  Matrix Corporate Office Park 259 Prospect Plains Rd Bldg M Cranbury, NJ 08512-3707

• 

  AmeriHealth Insurance Company of New Jersey

  1901 Market St Philadelphia, PA 19103

• 

  AmeriHealth Insurance Company of New Jersey

  PO Box 7218 Philadelphia, PA 19101-7218

The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

• Initial Complaint

  Date:03/07/2025

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  There was a cyber attack on Change healthcare with resulted in many organizations being impacted. We, South Jersey Coping *********** was one of them. We have had challenges receiving payment for issues related to this vendor outside of our control. Essentially, we provided services for Amerihealths members pursuant to our contract and were never paid. The checks were issued but then bounced. We provided all requested documentation at least 4 times and have not been reimbursed. No department has the same information and we keep getting bounced around with promises to resolve. Delay tactics appear to be the norm and we are closing on a year of not being paid money owed to us. These checks were part of a batch of checks that were distributed by an old vendor, and we were not advised of this transaction. So when we attempted to cash these checks, they were returned by our bank, imposing return fees to our bank account. This was advised to use after the fact, and since then, we have been trying to get these checks replaced with your new vendor. This process has been very challenging, because your system reflects that these checks have been cleared. Please keep in mind that your system does not automatically reflect returned check information. We are asking that you please review this information, and assist with having these checks replaced so that we can be properly reimbursed for the services that we provided to your members. .Chk# ******* $85.17 Ref# ******** Chk# ******* $170.34 Ref# ******** Chk# ******* $85.17 Ref# ******** Chk# ******* $85.17 Ref# ******** Chk# ******* $85.17 Ref# ******** Chk# ******* $85.17)

  Business Response

  Date: 03/19/2025

  We will contact the complainant directly

  Customer Answer

  Date: 03/31/2025

  
  Complaint: 23033261
  
  I am rejecting this response because:
  
  Although the business did reach out to us, they still have not resolved our matter. We resent materials that we have shared countless times. The business continues to state that they made the initial payment to us for services rendered, however, the detail they continue to miss is that the checks they sent bounced due to *********** changing their vendor without notice. We would love for this to be resolved without further delay and look forward to a speedy resolution. 
  
  
  Regards,
  
  ******* *****

  Business Response

  Date: 04/01/2025

  We are working with the complainant 

  Customer Answer

  Date: 04/02/2025

  
  Complaint: 23033261
  
  I am rejecting this response because we have not received any follow up after initial contact. Therefore, our issue remains the same.
  
  
  
  Regards,
  
  ******* *****

  Business Response

  Date: 04/04/2025

  We are working with the complainant 

  Customer Answer

  Date: 04/07/2025

  
  Complaint: 23033261
  
  I am rejecting this response because it was confirmed with my bank for the 2nd time that no funds were received from this payor and at this time according to our contract, they are in breech and out of compliance. This has literally been over a year with no sense of urgency. Meanwhile, clients and this business continue to be impacted.
  
  
  
  Regards,
  
  ******* *****

  Business Response

  Date: 04/17/2025

  We are working directly with the complainant 

  Customer Answer

  Date: 04/17/2025

  
  Complaint: 23033261
  
  I am rejecting this response because:
  There is still no response and resolve. No proof or conversation with their bank outside of the same checks they continue to send us as proof that were bounced. 
  
  
  Regards,
  
  ******* *****

  Business Response

  Date: 04/23/2025

  We are working directly with the complainant

  Customer Answer

  Date: 04/23/2025

  
  Complaint: 23033261
  
  I am rejecting this response because: if you notice the response continues to be the same. No updates just the same delay tactics. Please Id encourage anyone who wants to panel with this company to reconsider. Its been over a year and no one has contacted me from the bank to resolve this matter. No one has called me to resolve this matter. No one has given me any further information other than what I used to initially file this complaint. At this point, Im really disappointed that these institutions are permitted to treat their consumers and providers this way. There must be more advocacy and awareness around what insurance companies, particularly Amerihealth is doing that are in direct violation of their contractual agreement and state laws. If we cannot resolve this matter through this channel, my last hope is to peruse this in court unfortunately.
  
  
  
  Regards,
  
  ******* *****

• Initial Complaint

  Date:01/10/2025

  Type:Billing Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Amerihealth Administrators has not paid my primary care doctor for my annual preventative health visit, and flu shot. They have also not paid the claim for my annual preventative bloodwork and testing. They are required to pay the full amount for my in-network annual preventative physical, flu shot, and preventative bloodwork under the ACA. Instead, they have not paid the claims and continue to delay processing and payment of the claim for no good reason.
  
  My claim with them for my annual physical which was on 9/12/24 under claim number **** **** ***** has still not been paid, and payment is due to my doctor on 1/11/2025. They denied paying anything toward this the claim on 11/26/24, not one cent despite it being a fully covered preventative visit. I called them to have the claim reprocessed on 11/27/2024; a that time they agreed the claim should be paid in full since it is a preventative visit and said they would expedite payment, which they did not do. I spoke with them again on 1/5/2025 and the claim is still not reprocessed or paid (Reference numbers # ******** and ********) To date, they have still not paid this claim, which was submitted about four moths ago, claim and is going to be past due as of 1/11/2025.
  
  My claim and invoice for my preventative annual bloodwork with Labcorp under claim number
  ************* was also wrongly denied, and remains pending and will also be past due soon. They are also required to pay for this preventative bloodwork and testing under the ACA.
  
  Amerihealth Administrators is engaging in improper business tactics by failing to promptly pay claims including preventative health claims as required under the law and plan contract. I am requesting full payment of $256.49 for the claim of **** **** ***** (For annual preventative visit and my annual flu shot) and Full payment of $49.40 (For annual preventative bloodwork and testing under the ACA immediately before these invoices become past due.

  Business Response

  Date: 01/27/2025

  We have responded directly to the complainant regarding their concerns

  Customer Answer

  Date: 01/28/2025

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  
  
  
  Better Business Bureau:
  
  
  
  I have reviewed the response made by the business in reference to complaint ID ********, and they have resolved this issue after you became involved.   

  I want to thank you for your efforts in securing a resolution in this matter. 

• Initial Complaint

  Date:08/08/2022

  Type:Sales and Advertising Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I have been ordering 8 free Covid tests through AmeriHealth's Optum store since February. This month, when I clicked the "order now" link to "Get at-home COVID-19 tests with $0 copay*", I receive an error message stating, "errorMessage": "Bad JWT token". I tried with multiple browsers and encountered the same issue. On Friday August 5, I called AmeriHealth NJ customer service to report the issue. After being disconnected several times and calling back, the agent I spoke to experienced the same problem and told me it was reported and that I should try again in 24 hours. 3 days later, I continued to experience the same issue. I was told I needed to call the Optum Store directly and that I should have been told that on Friday. I called the number I was given, which brought me to **************. The woman I spoke to was very dismissive, telling me she didn't know anything about free covid tests, but eventually provided me a number that was supposed to bring me to the Optum Store. After being on hold several more times and getting disconnected again, that number eventually brought me to US Healthcare who informed me they could not help Amerihealth customers. I called Amerihealth again and eventually got connected to an escalation specialist. She spent about 40 minutes with me on a conference call with a series of ************************ Eventually, I was told they would try to fix the broken website link but could not provide an ETA. They said there was no other way to order the covid tests besides the broken website link and said the only solution they could offer is that I go to a pharmacy and then submit a reimbursement form. I declined to do this because I want the tests shipped directly to me as I have done since February. I am currently waiting until the end of August to see if the website issue is resolved in time for me to obtain the 8 free tests I am entitled to this month. I am not optimistic and feel the system is designed to be difficult so people give up.

  Business Response

  Date: 08/16/2022

  Good afternoon,

   

  This matter was resolved. The member can order their COVID test without receiving an error message. AmeriHealth New Jersey would like to apologize for any inconvenience that this may have caused. Please let ** know if you need any additional information. 

   

  *****************
  Executive Inquiries Specialist
  1900 *******************************, ** 19103
  P ******************** 
  
  amerihealthnj.com