Resources
AmeriHealth Caritas VIP Care (Dual-Eligible Special Needs Plan) values excellent relationships with our health care providers. Together, we can work to improve the quality of and access to care for our members.
Use this section of our site to access the resources you need most, including:
Claims and billing
Claim submission/payment information:
- Electronic Claims Submission
- Payer ID: 87406
- Paper Claims Submission:
AmeriHealth Caritas VIP Care
Claims Processing Department
P.O. Box 7125
London, KY 40742-7125
- Electronic Funds Transfer/Electronic Remittance Advice Enrollment
- Change Healthcare customer support is available through online chat, or call 1-800-527-8133, option 2 for assistance.
Other claim information:
- Appropriate usage of claims modifiers 25 and 59 (PDF)
- CES Explanation Codes (PDF)
- Common Errors on Claims Submissions (PDF)
- Provider Claim Dispute Form (PDF)
- Waiver of liability form for nonparticipating provider appeals (PDF)
Contacts
- Provider Network Management Account Executive contact information email: delawareprovidernetwork@amerihealthcaritas.com
- Provider Services 1-833-433-2177
- Email - You can contact us by using our secure form.
Credentialing
Prior authorization
Provider manual
Quality
- Care for Older Adults (COA) Coding Chart (PDF)
- Care for Older Adults (COA) Provider Form (PDF)
- Clinical Resources
- CMS Five-Star Quality Rating System and Our Network Providers (PDF)
- Controlling Blood Pressure Claims Coding Chart (PDF)
- Diabetes Coding for HEDIS Form (PDF)
- HEDIS® Incentive Program (PDF)
- Medicare Risk Adjustment Overview and Documentation Guidance (PDF)
- PerformPlus® Gaps in Care Closure Program (PDF)
- Physical Activity in Older Adults (PDF)
- Preventive Services Quick Reference Guide
- Transitional Care Management with Medication Reconciliation Post-Discharge (PDF)
- Urinary Incontinence (PDF)
Training and Education
AmeriHealth Caritas VIP Care (HMO-SNP) provides training and education resources tailored to the needs of our new Medicare providers. We're always striving to offer a variety of different educational opportunities to help our participating providers give quality, expert care to our members.
Our current educational opportunities include:
- Cultural competency training
- Fraud, Waste, and Abuse
- Model of Care training
- Resources for Integrated Care — Resources for dual eligibles
- Training Modules
Working with AmeriHealth Caritas VIP Care
- Dental Reference Guide (PDF)
- Marketing activities and compliance
- Provider Reference Guide (PDF)
- Service area map (PDF)
- Reimbursement Policies
Check back frequently, since we'll be updating this section to include the latest information for our providers. Our participating providers can also call AmeriHealth Caritas VIP Care Provider Services at 1-833-433-2177
If you are not yet a participating provider, and you would like more information on the benefits of partnering with us, contact Provider Services at 1-833-433-2177.
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