U P D A T EW O R K I N G T O G E T H E R F O R Q U A L I T Y H E A L T H C A R E

HealthP A R T N E R S

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INSIDE THIS ISSUE: MARCH 2006ANNOUNCEMENTS• 2005 Coding Guidelines and Policy Update (CGPU) Compendium Enclosed

QUALITY MANAGEMENT• Practitioner Site Visit Assessment to Promote Member Safety (NJ only)• PCP Satisfaction with Information Received from Organizational Providers and Specialists (NJ only)

NAVINETSM ANNOUNCEMENTS• NaviNetSM: Get Connected

REMINDERS• Provider Supply Line: For Offi ce Supplies and Resources

FOR YOUR PATIENT’S HEALTH• ConnectionsSM Health Management Program Adds Depression Screening Initiative• AmeriHealth Provides Coverage for First Trimester Screening• Encourage Members to Receive Colorectal Cancer Screening• Supporting Our Members, Your Patients: ConnectionsSM Health Management Programs

Billing for Neonatal Hearing Screening Should be Directed to FacilityAmeriHealth has recently received inquiries from members who received bills for hearing screenings provided to their newborns before discharge from a facility.

Please be advised that newborn hearing screenings are covered services and included within the facility’s payment for the delivery and are not eligible for separate billing to AmeriHealth or to the member. In the event that a provider has a contract

or arrangement with a facility to provide these screenings, the provider must look to that facility for payment and not to AmeriHealth or to our members.

Please call Provider Services or your Network Coordinator with any questions.

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ANNOUNCEMENTS (continued)

2005 Coding Guidelines and Policy Update (CGPU) Compendium EnclosedEnclosed is the annual 2005 Coding Guidelines and

Policy Update (CGPU) Compendium. Th e Compendium includes policy summaries published in the past four issues of the quarterly CGPU along with other information that can simplify information retrieval and claims submission processes.

Th e Compendium also includes previously published articles on the class action settlement, modifi er updates, and changes in policy criteria, and a section detailing new, revised, and deleted Current Procedural

Terminology (CPT)*, Healthcare Common Procedure Coding System (HCPCS), and ICD-9 CM codes.

*Current Procedural Terminology (CPT®) is a copyright of the American Medical Association (AMA). All Rights Reserved. No fee schedules, basic units, relative values, or related listings are included in CPT. Th e AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use. CPT® is a trademark of the AMA.

QUALITY MANAGEMENT

Practitioner Site Visit Assessment To Promote Member Safety (NJ Only)AmeriHealth’s Quality Management department has established a Member Safety Program designed to promote safe clinical care and a reduction in medical or medication errors. Member safety indicators are identifi ed and monitored through various sources of data to identify potential safety issues and current initiatives to improve member safety. Included in the assessment are the results following practitioner site

visit monitoring. Plan-wide performance rates for each of the 12 safety-related indicators are assessed to identify opportunities for improvement and promote safe clinical practices.

Practitioner site visits were completed on a total of 420 PCP and OB/GYN offi ce sites in 2005. Rates for all sites assessed in 2004 and 2005 are noted in the table below:

Member Safety Site Visit Indicators (2004-2005)

Safety IndicatorsPercent Compliant2004

(602 sites)2005

(420 sites)1. Presence of a system to comply with OSHA regulations. 99.7% 100.0%2. Procedure to clean/sanitize or replace equipment. 95.1% 100.0%3. Evidence that equipment receives preventive maintenance

(electrocardiogram [EKG], audiometer, tympanometer, sigmoidoscope, etc.). 99.0% 100.0%

4. Drugs, prescription pads, and syringes are not patient accessible. 73.0% 99.5%5. Presence and use of sharps disposal (impermeable container). 96.5% 95.7%6. Corridors and rooms are uncluttered and free of obstruction. 95.9% 100.0%7. Presence of a system to monitor use of controlled drugs. 99.5% 97.3%8. Presence of a fi re extinguisher. 99.7% 95.7%9. Biologicals are refrigerated and stored properly. 99.7% 96.3%10. Fire exits are clearly marked. 99.6% 95.0%11. Presence and use of contaminated waste containers (red bag trash). 93.9% 68.8%

12. Availability of a separate area for laboratory services. 99.3% 100.0%

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QUALITY MANAGEMENT (continued)

Practitioner Site Visit Assessment To Promote Member

Safety (NJ Only) (continued)

Overall, the results of the practitioner site visit monitoring demonstrate a high level of compliance with rates of 95% or greater for 11 of the 12 safety indicators. In comparing the results of the 2005 assessment to the results from 2004, improvement is noted for 5 of the 12 safety-related indicators, most notably for drugs, prescription pads, and syringes are

not patient accessible, which demonstrated the greatest improvement (73.0% to 99.5%). One indicator, presence of use of contaminated waste containers (Red Bag

trash) demonstrated the greatest decline during the study period and the lowest rate in 2005 (93.9% to 68.8%). Practice sites are encouraged to use Red Bag contaminated waste containers to ensure safe practices at practitioner sites.

AmeriHealth appreciates your continued eff orts to promote member safety in the provision of clinical care healthy outcomes for your patients.

PCP Satisfaction With Information Received From Organizational Providers and Specialists (NJ Only)AmeriHealth New Jersey monitors and takes appropriate action to improve the continuity and coordination of care between PCPs, specialists, and organizational providers (hospitals, ambulatory surgery centers, skilled nursing facilities, and emergency rooms). Th e PCP satisfaction survey is utilized to assess satisfaction with the rate of receipt and exchange of

information between PCPs and specialists as well as between PCPs and these four organizational provider types. In 2005, surveys were mailed to all PCP practices in the AmeriHealth New Jersey network with 50 or more members (453) with a 54% response rate. Th e results of these studies are as follows:

Table 1Receipt of Discharge Summary (Most/Always) (2005)

Organizational Provider Type Receipt of Discharge Summary

Hospital 65%

Skilled Nursing Facility (SNF) 45%

Outpatient Surgery 45%

Emergency Room (ER) 48%

(Continued on next page)

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PCP Satisfaction With Information Received From Organizational Providers and Specialists (NJ Only) (continued)

QUALITY MANAGEMENT (continued)

Table 3PCP Satisfaction with Exchange of Information with Specialists and Labs

Specialist Type Frequency Quality Timeliness Confi dentiality

Cardiology 84% 85% 81% 82%Endocrinology 76% 78% 73% 82%Allergy/Immunology 75% 78% 74% 80%Pulmonary 82% 83% 78% 81%Ophthalmologists/Optometrists

74% 80% 76% 88%

Labs 83% 87% 84% 88%

Th e PCP satisfaction survey refl ects that PCPs were most satisfi ed with the rate of receipt of discharge summaries from hospitals. Th e rates of receipt of discharge summaries from SNFs, Outpatient Surgery, and ERs were only 45% to 48%.

PCP satisfaction with confi dentiality of the fl ow of information from the four organizational providers was greater than 70% overall. PCPs were most satisfi ed with the frequency and quality of the exchange of information with hospitals. Th ey were least satisfi ed with the frequency of information exchange with SNFs. With respect to timeliness, PCP satisfaction was highest with Outpatient Surgery sites; however, rates of satisfaction with the timeliness of information exchange were less than 50% for Hospitals, SNFs, and ERs. PCP satisfaction with the fl ow of information from the specialists included in the survey and with Labs was high overall (73% to 88%).

AmeriHealth will take steps to reinforce the importance of timely and appropriate dissemination of discharge information by participating organizational providers. We also encourage PCPs and specialists to ensure the exchange of information and to provide feedback to facilities, as appropriate, regarding the frequency, quality, timeliness, and confi dentiality of information received from organizational providers.

Provider Type Frequency Quality Timeliness Confi dentialityHospital 57% 67% 49% 77%SNF 43% 51% 45% 72%Outpatient Surgery 51% 62% 52% 75%ER 54% 55% 43% 74%

Table 2PCP Satisfaction with Exchange of Information with Organizational Providers (2005)

PCPs were also asked to assess their satisfaction with the exchange of information with selected high volume specialists (Cardiologists, Endocrinologists, Allergists, Pulmonologists, Ophthalmologists/Optometrists) and

Labs to ensure continuity and coordination of care in the management of chronic conditions such as diabetes, asthma and coronary artery disease.

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NAVINETSM ANNOUNCEMENTS

NaviNetSM: Get ConnectedTo increase effi ciency and productivity in your offi ce, we encourage you to use NaviNetSM, the HIPAA-compliant Web-based connectivity solution off ered by NaviMedix®, Inc.

NaviNetSM is a fast and effi cient way to interact with AmeriHealth and may reduce the time and costs associated with health care administration. By accessing NaviNetSM, you may connect with our back-end systems to streamline many of your daily administrative tasks, thereby eliminating unnecessary telephone inquiries and paper transactions.

NaviNetSM Plan Transactions include, but are not limited to: Eligibility and Benefi ts Inquiry (for local and out-of-area members), PCP and OB/GYN Referral Submission, Encounter Submission, Referral and Authorization Status Inquiry, Drug Preauthorization, Preauthorization Submission, Claim Status Inquiry, and the Provider Change Form.

Provider Supply Line: For Offi ce Supplies and Resources To replenish offi ce supplies (e.g., Provider Manuals, directories, and Clinical Practice Guidelines), please call the toll-free Provider Supply Line at (800) 858-4728 and have the following information ready so your order may be processed in an error-free, timely manner:

• Provider identifi cation number

• Offi ce name

• Offi ce address

• Offi ce telephone number

If any information is missing, your order may not be processed. If an order is submitted correctly, it may take three to fi ve business days to receive your request. If you are unsure of your provider identifi cation number, contact Provider Services or your Network Coordinator.

Please note: Calls to the Provider Supply Line should be related to supply requests only. All other provider inquiries should be directed to Provider Services. Orders placed through Provider Services will not be accepted.

REMINDER

NaviNetSM Portal UsersHow do I attend a NaviNetSM Online Training class?

To schedule a live class, call NaviNetSM Customer Careat (888) 482-8057.

All classes are recorded. You may view classes you previously attended by clicking the Online Training Tab found at the top

of the Plan Central website.

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FOR YOUR PATIENT’S HEALTH

In spring 2006, the ConnectionsSM Health Management Program will implement a new decision support initiative focused on depression screening. Depression is a common comorbidity of many chronic conditions such as diabetes, heart disease, and chronic pain. While these patients may be at risk for depression, the diagnosis can be easily missed without a systematic approach to screening.

Identifi ed patients with chronic conditions such as diabetes, CHF, CAD, COPD, chronic fatigue syndrome, and fi bromyalgia who are also at risk for depression, will receive a mailing which includes the Patient Health Questionnaire (PHQ-9). Patients will be instructed to self-administer the test and to bring

the completed tool to their next offi ce visit to discuss with their health care provider.

To assist Primary Care Physicians (PCPs) with interpreting the information provided by the PHQ-9, Connections Provider Service Specialists will provide PCPs with a kit of educational materials and tools.

To refer a patient or for questions about the ConnectionsSM Program, call the Connections Provider Support Line at (866) 866-4694.

Please refer to Spring Clinical Update for additional information on the Depression Screening Initiative.

ConnectionsSM Health Management Program Adds Depression Screening Initiative

AmeriHealth Provides Coverage For First Trimester Screening AmeriHealth provides coverage for fi rst trimester prenatal screening for fetal aneuploidy (chromosome number abnormalities). Th e screening, which involves blood screenings and an ultrasound, can identify fetuses at risk for Trisomy 21 (Down Syndrome) and Trisomy 18. First trimester screening for fetal aneuploidy approximates the accuracy of second trimester quadruple screening, with the advantage of allowing decision-making at an earlier stage of pregnancy.

AmeriHealth’s contracted reference laboratories—including Abington Memorial Hospital, Hospital of University of Pennsylvania, LabCorp, Quest

Diagnostics, and Genzyme—off er blood screenings and will run risk algorithms based on ultrasonic nuchal translucency (NT) measurements and blood work results. Please use the HMO OB Referral Form to request fi rst trimester NT and serum screening. Also, please check to see that your perinatology unit is certifi ed to obtain NT measurements; that unit will perform the ultrasound and complete the lab referral with their results and certifi cation number.

For more information, please refer to Spring Clinical

Update.

Encourage Members To Receive Colorectal Cancer Screening AmeriHealth and the American Cancer Society (ACS), urge you to encourage your patients to be screened for colorectal cancer. AmeriHealth is providing OB/GYN, PCP, and GI practitioners with the enclosed materials that we hope will make it easier when discussing national recommendations with your patients. Please know that your personal recommendation has a tremendous infl uence on a patient’s decision to seek recommended preventive health screenings.

Adherence to the colorectal cancer screening guidelines may lead to improved patient outcomes. Individual

clinical decisions should be tailored to specifi c patient medical and psychosocial needs. Although this information is adapted from national sources, information in this area may evolve rapidly and can lead to changes in recommendations. As changes occur, please update your practice accordingly.

Note: Th is is not a statement of benefi ts. Benefi ts may vary based on state requirements, product line (HMO, PPO, etc.), and/or employer group. HMO and PPO member coverage may be verifi ed through Provider Services.

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Supporting Our Members, Your Patients: ConnectionsSM Health Management Programs Since July 2003, AmeriHealth has been implementing an enhanced disease management program called ConnectionsSM Health Management Programs. To date, these programs include the ConnectionsSM Health Management Program, the ConnectionsSM Kidney Program, and the ConnectionsSM AccordantCareTM Program. Details on the programs are included below.

When treating patients with multiple chronic conditions, consider the following guidelines for referring patients for disease management support:

• ConnectionsSM Kidney Program is the primary disease management program for the patient with ESRD and on chronic dialysis.

• ConnectionsSM AccordantCareTM Program is the primary disease management program for the patient with any one of the 15 complex chronic conditions covered by this program, unless they have ESRD.

• ConnectionsSM Health Management Program is the primary disease management program for the patient who has one or more of the fi ve chronic conditions (diabetes, asthma, CHF, COPD, CAD) supported by this program but who does not have a co-morbid condition covered by the other Connections programs.

• Any patient seeking decision support at any time, may access a ConnectionsSM Health Management Program health coach.

• In certain limited cases, more than one support program may work with you and your patient, after consideration of the patient’s individual needs.

Providing resources for you and your patients with End-Stage Renal Disease (ESRD)CONTACT THE CONNECTIONSSM KIDNEY PROGRAM AT (866) 303-4CKP [4257] TO:

Refer a member on chronic outpatient dialysis to a Health Service Coordinator. Ask questions and/or provide feedback. Request individual member information.3

21

Helping you and your patients manage fi ve chronic conditions (Asthma, CAD, CHF,

COPD, and Diabetes)

CONTACT THE CONNECTIONSSM HEALTH MANAGEMENT PROGRAM PROVIDER SUPPORT LINE AT (866) 866-4694 TO:

Refer a member with asthma, CHF, CAD, COPD, and/or diabetes for Health Coaching. Refer a member for “treatment option Decision Support.” Ask questions or provide feedback. Request information regarding the SMARTTM

Registry. Request ConnectionsSM posters for your

offi ce, referral pads, and copies of Clinical Insights.

Request individual patient information for the purposes of treatment and care coordination for your patient.

A ConnectionsSM Provider Service Specialist will return your call within two business days.

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Promoting self-management and preventing disease complications for patients with complex

chronic conditions

CONTACT THE CONNECTIONSSM ACCORDANTCARETM PROGRAM AT

(866) 398-8761 TO:

Refer patients with the following complex chronic conditions for disease management support:

• Seizure Disorders • Scleroderma

• Rheumatoid Arthritis • Polymyositis

• Multiple Sclerosis • Dermatomyositis

• Parkinson’s Disease• Systemic Lupus

Erythematosus (SLE)• Myasthenia Gravis• Sickle Cell Disease• Cystic Fibrosis• Hemophilia

• Chronic Infl ammatory Demyelinating Polyradiculoneuropathy (CIDP)

• Amyotrophic Lateral Sclerosis (ALS)

• Gaucher Disease Ask questions and/or provide feedback. Request an individual patient disease

management plan for the purposes of care coordination for your patient.

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PROVIDER INFORMATION and TOOLS WEB PAGEwww.amerihealth.com/providers

PROVIDER MEDICAL POLICY WEB PAGEwww.amerihealth.com/medpolicy

PROVIDER ELECTRONIC DATAINTERCHANGE SERVICES WEB PAGEwww.amerihealth.com/edi

CORPORATE AND FINANCIAL INVESTIGATIONS DEPARTMENT Anti-Fraud and Corporate Compliance Hotline(866) 282-2707www.amerihealth.com/anti-fraud

CREDENTIALING COMPLIANCE HOTLINE (866) 282-2707www.amerihealth.com/credentials

PROVIDER PHARMACY WEBPAGEwww.amerihealth.com/provider_rx

eBUSINESS PROVIDERINQUIRY LINE(856) 638-2701 NJ(302) 661-6111 DE

PROVIDER SERVICESPolicies/Procedures/Claims

HMO(800) 821-9412 NJ(800) 888-8211 DE

PPO(800) 595-3627 NJ(800) 888-8211 DE

PHARMACY SERVICESPrescription Drug Authorization(888) 671-5280

Toll-Free Fax(888) 671-5285

Direct Ship Injectable(267) 402-1711(888) 671-5280

Fax(215) 761-9165

Blood Glucose Meter Hotline(888) 494-8213 (option 2)

PROVIDER SUPPLY LINE(800) 858-4728

HEALTH RESOURCE CENTER

AmeriHealth Healthy LifestylesSM (800) 275-2583

Precertifi cation(800) 227-3116

CARE MANAGEMENT AND COORDINATION HMO Commercial(800) 227-3116 NJ(800) 373-4455 DE

PPO(800) 373-4455

Case Management(800) 313-8628 NJ(800) 373-4455 DE

Baby FootSteps®

(800) 598-BABY [2229]

CONNECTIONSSM HEALTH MANAGEMENT PROGRAMS PROVIDER SUPPORT LINE (866) 866-4694

CONNECTIONSSM KIDNEY PROGRAM (866) 303-4CKP [4257]

CONNECTIONSSM ACCORDANTCARETM PROGRAM (866) 398-8761

The AmeriHealth Partners in Health Monthly Update is a publication of the Provider Communications department for the exchange of information and ideas among the AmeriHealth Provider community. Suggestions are welcome.

Contact Information:

Rosemary FranksManaging Editor

Elizabeth DeragoProduction Coordinator

Provider CommunicationsAmeriHealth1901 Market Street, 35th FloorPhiladelphia, PA 19103

Visit our website at www.amerihealth.com

AmeriHealth products are offered directly by QCC Insurance Company d/b/a AmeriHealth Insurance Company, AmeriHealth HMO, Inc. and AmeriHealth Insurance Company of New Jersey.

The third-party Web sites mentioned in this publication are maintained by organizations over which AmeriHealth exercises no control, and accordingly, AmeriHealth disclaims any responsibility for the content, the accuracy of the information, and/or quality of products or services provided by or advertised in these third-party sites. URLs presented for informational purposes only. Certain services/treatments referred to in third-party sites may not be covered by all benefi t plans. Members should refer to their benefi t contract for complete details of the terms, limitations, and exclusions of their coverage.

Current Procedural Terminology (CPT®) is a copyright of the American Medical Association (AMA). All Rights Reserved. No fee schedules, basic units, relative values, or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use. CPT® is a trademark of the American Medical Association.

Investors in NaviMedix®, Inc. include an affi liate of AmeriHealth, which has a minority ownership interest in NaviMedix®, Inc.

View our online provider directories at www.amerihealth.com.

009189 2003-0269 07/05

IMPORTANT RESOURCES

The following pages of this PDF include content that originally mailed with the March edition of Partners in Health Update. These documents have been combined into

one PDF file on IBC’s website & Provider Manual CD for your convenience.

ENCLOSURES

AmeriHealth HMO, Inc.

Important Information Regarding Dual Eligible AmeriHealth 65®

Members

As you know, effective January 1, 2006, the Centers for Medicare & Medicaid Services

(CMS) authorized AmeriHealth to passively enroll full dual eligible Medicare beneficiaries

from our affiliated plan—AmeriHealth Mercy—into the AmeriHealth 65® Medicare

Advantage Special Needs Plan called AmeriHealth 65. Some members were unable to be

matched to the PCP they had previously selected through AmeriHealth Mercy, which

resulted in these members being issued identification cards with no designated PCP.

While AmeriHealth 65 is making every attempt to contact these members, if you identify

dual eligible AmeriHealth 65 members with no designated PCP while providing services in

your office, please instruct them to select a PCP by calling the Member Services

telephone number on the back of their AmeriHealth 65 member ID card.

Also, please note that an initial continuity of care period was established for all passively

enrolled AmeriHealth 65 members through March 31, 2006. This allows claims payment for

members who may receive services without a PCP referral. AmeriHealth 65 is extending

this continuity of care period through April 30, 2006. However, after that time, all

managed care rules will be in place and claims without a designated PCP referral may

reject.

You will receive a provider letter with additional information regarding Dual Eligible

AmeriHealth 65 Members in early April.

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Starting a conversation with your patients about colorectal cancer screening may help save a life.

The American Cancer Society (ACS) estimates that approximately 148,610 new cases of colorectal cancer will bediagnosed this year alone.

To help you help your patients, AmeriHealth and the ACS are providing you with patient education materials thatcan assist you with recommending and discussing colorectal cancer screening with your patients.

The current ACS guidelines offer several different screening options. These options are reflected in AmeriHealth’sPreventive Health Guidelines that can be accessed at www.amerihealth.com.* The best screening test is the test thatyour patient will get.

Enclosed for your use are the following educational tools:

• Colorectal Cancer “No Excuses” Brochure (English version)• Colorectal Cancer “No Excuses” Brochure (Spanish version)• Colorectal Cancer Prevention Pocket Card (for Physicians)

Please be advised that based on a recently published study of 2,665 patients,1 fecal occult blood testing (FOBT)on a single stool sample obtained by digital rectal exam is not recommended as an adequate screening measure.Instead, if FOBT is selected, then the multiple sample FOBT method is recommended.

If you would like additional copies of any of the above materials, please contact our Provider Supply line at(800)858-4728 and indicate the materials you would like sent to you. This offer is available only while supplies last.

For additional cancer-related information, including information on colorectal cancer screening and communityresources, please provide patients with the ACS’s toll-free number, (800) ACS-2345, or its website:www.cancer.org.**

AmeriHealth would like to take this opportunity to remind you about the ConnectionsSM Health ManagementPrograms. These programs provide chronic condition and decision support services to AmeriHealth members. Ifyou would like more information about ConnectionsSM, or if you would like to refer a patient for Health Coaching,please call the ConnectionsSM Provider Support Line at (866) 866-4694.

Thank you for your assistance in promoting awareness of colorectal cancer prevention. Together we can make animpact in helping to control cancer.

Yours in good health,

Allan B. Goldstein, M.D., F.A.C.P. Alfred R. Ashford, M.D.Vice President and Regional Medical Director Chief Medical Spokesperson

AmeriHealth, New Jersey American Cancer Society

1 Collins, J.F., Lieberman, D.A., Durbin, T.E., Weiss, D.G., Veterans Affairs Cooperative Study #380 Group. "Accuracy of Screening for Fecal Occult Blood on a Single Stool SampleObtained by Digital Rectal Examination: A Comparison with Recommended Sampling Practice." Annals of Internal Medicine. Jan. 18, 2005. Volume 142. pp. 81-85.

* This is not a statement of benefits. Benefits may vary according to state requirements, product line (HMO, PPO, etc.) and/or employer group. HMO and PPO member coverage maybe verified through Provider Services.

** Please be advised that these websites are maintained by organizations that AmeriHealth does not control. The websites are to be used as a reference for informational purposes only.AmeriHealth is not responsible for the content or for validating the content, nor is it responsible for any changes or updates made. Once you link to a website not maintained byAmeriHealth, you are subject to the terms and conditions of that website, including but not limited to its privacy policy. This information has been provided for general educationalpurposes for professional medical personnel only. It is not intended to be relied upon for treatment of an individual patient without a physician's independent professional review.

IMPORTANT INFORMATION REGARDING COLORECTAL CANCER SCREENING

AH NJ Colorectal letter.qxd 3/8/2006 10Q25 AM Page 1

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www.amerihealth.com

Starting a conversation with your patients about colorectal cancer screening may help save a life.

The American Cancer Society (ACS) estimates that approximately 148,610 new cases of colorectal cancer will bediagnosed this year alone.

To help you help your patients, AmeriHealth and the ACS are providing you with patient education materials thatcan assist you with recommending and discussing colorectal cancer screening with your patients.

The current ACS guidelines offer several different screening options. These options are reflected in AmeriHealth’sPreventive Health Guidelines that can be accessed at www.amerihealth.com.* The best screening test is the test thatyour patient will get.

Enclosed for your use are the following educational tools:

• Colorectal Cancer “No Excuses” Brochure (English version)• Colorectal Cancer “No Excuses” Brochure (Spanish version)• Colorectal Cancer Prevention Pocket Card (for Physicians)

Please be advised that based on a recently published study of 2,665 patients,1 fecal occult blood testing (FOBT)on a single stool sample obtained by digital rectal exam is not recommended as an adequate screening measure.Instead, if FOBT is selected, then the multiple sample FOBT method is recommended.

Enclosed is a “Colorectal Cancer Screening Physicians Office Educational Materials Order Form” so that you mayorder additional copies of the tools for use in your office and for distribution to your patients.

For additional cancer-related information, including information on colorectal cancer screening and communityresources, please provide patients with the ACS’s toll-free number, (800) ACS-2345 or its website: www.cancer.org.**

AmeriHealth would like to take this opportunity to remind you about the ConnectionsSM Health ManagementPrograms. These programs provide chronic condition and decision support services to AmeriHealth members. Ifyou would like more information about ConnectionsSM, or if you would like to refer a patient for Health Coaching,please call the ConnectionsSM Provider Support Line at (866) 866-4694.

Thank you for your assistance in promoting awareness of colorectal cancer prevention. Together we can make animpact in helping to control cancer.

Yours in good health,

Richard L. Snyder, M.D. Allison GilVice President Regional Mission Delivery DirectorQuality Management American Cancer SocietyAmeriHealth South Atlantic Divison1 Collins, J.F., Lieberman, D.A., Durbin, T.E., Weiss, D.G., Veterans Affairs Cooperative Study #380 Group. "Accuracy of Screening for Fecal Occult Blood on a Single Stool SampleObtained by Digital Rectal Examination: A Comparison with Recommended Sampling Practice." Annals of Internal Medicine. Jan. 18, 2005. Volume 142. pp. 81-85.

* This is not a statement of benefits. Benefits may vary according to state requirements, product line (HMO, PPO, etc.) and/or employer group. HMO and PPO member coverage maybe verified through Provider Services.

** Please be advised that these websites are maintained by organizations that AmeriHealth does not control. The websites are to be used as a reference for informational purposes only.AmeriHealth is not responsible for the content or for validating the content, nor is it responsible for any changes or updates made. Once you link to a website not maintained byAmeriHealth, you are subject to the terms and conditions of that website, including but not limited to its privacy policy. This information has been provided for general educationalpurposes for professional medical personnel only. It is not intended to be relied upon for treatment of an individual patient without a physician's independent professional review.

IMPORTANT INFORMATION REGARDING COLORECTAL CANCER SCREENING

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COLORECTAL CANCER SCREENING Physician’s Office Educational Materials

Free of Charge

If you or someone you know has cancer, the American Cancer Society (ACS) can help! Please provide patients with the ACS’s toll-free number, (800) ACS-2345,

or its website: www.cancer.org

Order Form For Patients Quantity

• Colorectal Cancer “No Excuses” Brochure (English version) 50 or 100

• Colorectal Cancer “No Excuses” Brochure (Spanish version) 50 or 100

For Physicians Quantity Colorectal Cancer Prevention/Pocket Card (for physician use) Send to: County: ______________________________________________________________________ Physician/Practice Name: ____________________________Telephone: __________________ Attention: ____________________________________________________________________ Street Address: ________________________________________________________________ City: ________________________________________________________________________ Zip Code: _____________ E-mail Address: __________________________________________

Return to: American Cancer Society South Atlantic Division, Inc. Attention: Allison Gil 92 Read’s Way, Suite 205 New Castle, DE 19720 Fax: (302) 324-4233