Resources
AmeriHealth Caritas VIP Care (D-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:
Claims and billing
Claim submission/payment information:
- Electronic Claims Submission
- Payer ID: 73575
- Paper Claims Submission:
AmeriHealth Caritas VIP Care
Claims Processing Department
P.O. Box 7437
London, KY 40742-7437
- Direct entry claims submission through Change Healthcare's Connect Center
- Video Tutorial – Creating a Claim
- Submit a 275 claim attachment
- 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)
- Claim dispute form (PDF)
- Common Errors for Claims Submissions (PDF)
- Waiver of liability form for nonparticipating provider appeals (PDF)
Contacts
- Provider Network Management Account Executive contact information:
- Account Executives (PDF)
- Ancillary Account Executives (PDF)
- Hospital Account Executives (PDF)
- Provider Services 1-800-521-6007
Credentialing
- Credentialing
Prior authorization
- Prior authorization
- Prior Authorization Lookup Tool
Provider manual
Quality
- Adult Body Mass Index (BMI) Assessment Claims Coding Chart (PDF)
- Care for the Older Adults (COA) Claims Coding Chart (PDF)
- Care for Older Adults (COA) Form (PDF)
- Clinical resources
- CMS Five-Star Quality Rating System and Our Network Providers (PDF)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS®) and Health Outcomes Survey (HOS) Information (PDF)
- Diabetes Coding for HEDIS® (PDF)
- Controlling Blood Pressure Claims Coding Chart (PDF)
- HEDIS Incentive Program (PDF)
- Incentive Program - The PerformPlus Stars Total Cost of Care Program (PDF)
- Member wellness brochure: Live Well at Any Age — Seven tips to help you live a healthy, happy life as you grow older (PDF)
- Medicare Risk Adjustment Overview and Documentation Guidance (PDF)
- Preventive Services Quick Reference Guide
- Promoting Physical Activity Notice (PDF)
- Transitional Care Management With Medication Reconciliation Post-Discharge Notice (PDF)
- Urinary Incontinence Notice (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 learning opportunities to help our participating providers give quality, expert care to our members.
Our current learning opportunities include:
- Training modules
- Model of Care training
- Cultural competency training
- Resources for Integrated Care — Resources for dual eligibles
- Fraud Waste and Abuse
Working with AmeriHealth Caritas VIP Care
- Grievances
- 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 1-833-852-4767.
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 1-800-521-6007.
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