Important Information Regarding HEDIS® Data Collection
AmeriHealth Caritas VIP Care requests your cooperation with our efforts to collect medical record data for our members for annual Healthcare Effectiveness Data and Information Set (HEDIS®) reporting. The timeline for HEDIS record collection, review, and reporting is short, so we ask for your immediate attention to this request.
AmeriHealth Caritas VIP Care has contracted with PalmQuest Inc. to assist us with this year's medical record retrieval. PalmQuest is a company utilizing specialists trained in medical record retrieval for HEDIS, Centers for Medicare & Medicaid Services (CMS), and state quality reporting programs. PalmQuest is required to comply with Health Insurance Portability and Accountability Act (HIPAA) privacy requirements throughout the retrieval process.
This data collection is permitted under HIPAA legislation. Covered entities, including health plans and providers, are permitted to use and disclose protected health information to carry out treatment, payment, or health care operations in accordance with the HIPAA Privacy Rule (see 45 C.F.R. §164.502 (a)(1)(ii)).
AmeriHealth Caritas is pleased to welcome our AmeriHealth Caritas VIP Care participating providers. As an AmeriHealth Caritas VIP Care provider, you are a part of a dedicated network that is ready to meet our members' health care needs. As partners in care, we'll work with you to ensure that our members receive access to the quality health care they need and deserve, through a plan which features:
- A coordinated care approach.
- Leading technology solutions.
- Innovative community outreach programs that offer better health outcomes to our members.
Our robust network is designed to provide our members with integrated care. You will find other committed providers like you in the directories below:
- Find a Provider
Search for a PCP, specialist, hospital, or other health care provider in our network. Provider data contained within the online directory is updated daily Monday through Friday.
- Pharmacy directory (PDF — December 28, 2021)
See a list of all of the pharmacies in our network.
If you notice any errors in the directory, please fax, on practice letterhead, the information as it should appear, to the attention of Provider Services at 1-800-521-6007, Monday through Friday, 8 a.m. – 8 p.m., from April 1 to September 30; or seven days a week, 8 a.m. – 8 p.m., from October 1 to March 31.
Want to join our network?
We're always looking for providers to join our network of care, so if you are not yet a participating provider and would like information on joining our network, call 1-866-533-5490. You can also read credentialing information for AmeriHealth Caritas VIP Care.
Other quick resources:
- Provider Manual (PDF)
- Credentialing information
- Prior authorization information
- Provider training materials
Please refer to the other provider links for additional information and resources. Check back often, as we continue to add and update provider materials, resources, trainings and communications. If you have any additional questions, call AmeriHealth Caritas VIP Care Provider Services at 1-800-521-6007, Monday through Friday, 8 a.m. – 8 p.m., from April 1 to September 30; or seven days a week, 8 a.m. – 8 p.m., from October 1 to March 31.