HIPAA Privacy Practices and Forms
AmeriHealth Administrators is committed to protecting the privacy of our customers’ personal health information. As a Business Associate, part of that commitment is complying with the Privacy Rule of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which requires us to take additional measures to protect personal information and to inform our customers about those measures.
General HIPAA Information
HIPAA Privacy Forms
For your convenience, download and print any of the following HIPAA forms as needed:
Authorization to Release Information
Request for Copies of PHI
Request for Confidential Communication of PHI
Request for Limitations and Restrictions of PHI
Amendment Request
Revocation of Access
Request for Accounting of Disclosures of PHI
Personal Representative Request
Mail or fax the completed and signed forms to:
AmeriHealth Administrators
Attn: Privacy Office
720 Blair Mill Road
Horsham, PA 19044
Fax: 215-238-7993
Phone: 215-830-2579
HIPAA Transactions for Providers
For information about HIPAA-compliant transactions, visit the Electronic Data Interchange (EDI) Services section.
HIPAA Privacy Inquiries
If you have questions or comments regarding HIPAA Privacy, please submit an inquiry.






