AmeriHealth Caritas VIP Care (HMO-SNP) 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:
- Change Healthcare customer support is available through online chat, or call 1-800-527-8133, option 2 for assistance.
- Electronic Funds Transfer/Electronic Remittance Advice/Virtual Credit Card Enrollment
Other claim information:
- Appropriate usage of claims modifiers 25 and 59 (PDF)
- Claims dispute form(PDF)
- Waiver of liability form for nonparticipating provider appeals (PDF)
AmeriHealth Caritas VIP Care (HMO-SNP) is responsible for the credentialing and recredentialing of its provider network. All providers credentialed by AmeriHealth Caritas VIP Care must also be enrolled with the Medicare program and, as such, must agree to comply with all pertinent Medicare regulations.
AmeriHealth Caritas VIP Care works with the Council for Affordable Quality Healthcare (CAQH) to offer providers a Universal Provider Data source that simplifies and streamlines the data collection process for credentialing and recredentialing.
To obtain information on all the required credentialing documents, in addition to those found in a provider's CAQH record − or for providers who prefer a paper credentialing process − please contact AmeriHealth Caritas VIP Care Provider Services for assistance at 1-833-350-3477 or your local Account Executive.
Additional credentialing information:
For a complete list of the types of providers and facilities that AmeriHealth Caritas VIP Care is responsible for credentialing, see the Provider Manual (PDF) (Coming soon).
Practitioner and organizational provider credentialing rights
After the submission of applications, health care providers have the following rights:
- To review information submitted to support their credentialing applications, with the exception of references, recommendations, and peer-protected information obtained by the plan.
- To correct erroneous information. When information obtained by the Credentialing department varies substantially from information provided by the provider, the Credentialing department will notify the provider to correct the discrepancy.
- To be informed, upon request, of the status of their credentialing or recredentialing applications.
- To be notified within 60 days of the Credentialing Committee or Medical Director review decision.
- To appeal any credentialing or recredentialing denial within 30 days of receiving written notification of the decision.
- To know that all documentation and other information received for the purpose of credentialing and recredentialing is considered confidential and is stored in a secure location that is only accessed by authorized plan associates.
- To receive notification of these rights.
To request anything mentioned above, providers should contact the AmeriHealth Caritas VIP Care Corporate Credentialing department at:
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:
- Model of Care training
- Cultural competency training
- Resources for Integrated Care — Resources for dual-eligible programs
Provider Network Management Account Executive contact information:
- AmeriHealth Caritas Join our Network
- Provider Network Management Account Executive contact information:
- Provider Services 1-833-350-3477
- Email - You can contact us by using our secure form
- Care for Older Adults (COA) Provider Form (PDF)
- Controlling Blood Pressure Claims Coding Chart (PDF)
- Diabetes Coding for HEDIS (PDF)
- HEDIS® Incentive Program (PDF)
- Medicare Risk Adjustment Overview and Documentation Guidance (PDF)
- Physical Activity in Older Adults (PDF)
- Transitional Care Management with Medication Reconciliation Post-Discharge (PDF)
- Urinary Incontinence (PDF)
Claims and billing
Claim submission/payment information:
- Electronic Claims Submission
- Payer ID: 88232
- Paper Claims Submission:
AmeriHealth Caritas VIP Care
Claims Processing Department
PO Box 7155
London, KY 40742-7155
- Direct entry claims submission through Change Healthcare’s Connect Center
- Video Tutorial – Creating a Claim
- Claims Dispute Form (PDF)
Working with AmeriHealth Caritas VIP Care
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 1-833-350-3477.
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 1-833-350-3477.