Our Network Benefits

What do you get when you join AmeriHealth Caritas? Besides our innovative, whole-person health programs, we offer a variety of dedicated provider benefits to help ease your administrative, including:

The support you need to do business and provide the best care for plan members:

• Dedicated local staff who meet face-to-face with providers on a routine basis.
• Regional and national provider councils and committees where you can offer input on program development and processes.
  • Learn how we work with federally qualified health centers.
• Patient-centered medical homes to encourage coordination of care and improve management of services.

The right electronic tools to support your practice and simplify administration:

• Claims submission through electronic data interchange (EDI).
• Electronic remittance advice (ERA).
• Electronic payment options — virtual credit card (VCC) and electronic funds transfer (EFT).
• Web-based reporting and electronic prior authorizations.
• Web-based portal where you can see claim statuses and updates.

Open communication between the plan and providers:

• Routine provider-focused communication including letters, newsletters, email alerts, fax blasts, and website updates.
• Provider workshops and roundtable meetings to obtain feedback.
• Statewide provider meetings to introduce our plan and its processes.
• An accessible Provider Network Management team and a provider support hotline available 24 hours a day, seven days a week.
• Peer-to-peer access to local Medical Directors.

Simplification of the provider credentialing* process:

• Through the Council for Affordable Quality Healthcare (CAQH), a Universal Provider Datasource that streamlines data collection for credentialing and recredentialing.
• The use of delegated credentialing for qualified large provider entities, as applicable.
• An accessible Credentialing team for assistance with enrollment and CAQH participation sponsorships.
• Quick turnaround times.

*If applicable for your state.