Managed Care Organization

How to Get Credentialed with AmeriHealth Caritas in Ohio

Network: Open
30-90 Days CAQH Required Delegated Credentialing

Quick Overview

Timeline

30 - 90 days

CAQH

Required

Re-credentialing

Every 3 year(s)

Delegated

Yes

Ohio-Specific Requirements

AmeriHealth Caritas Ohio participates in the Ohio Medicaid Managed Care program. Providers must first enroll with Ohio Medicaid through MITS, then apply to AmeriHealth Caritas via CAQH ProView. Active Ohio medical license and NPI are required. Service areas are organized by ODM managed care regions. The plan serves CFC, ABD, and Medicaid expansion populations in select regions across Ohio.

Step-by-Step Enrollment Process

1

Gather Required Documents

Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for Ohio.

2

Complete Your CAQH ProView Profile

AmeriHealth Caritas requires a current CAQH ProView profile. Create or update your profile at proview.caqh.org and attest within 120 days.

3

Submit Your Application

Submit your completed enrollment package to AmeriHealth Caritas. You can start the process at their enrollment portal.

4

Track & Follow Up

Credentialing typically takes 30-90 days. Monitor your application status and respond promptly to requests for additional information.

Required Documents Checklist

Board Certification

Conditional

Required if board certified; highly recommended

CV/Resume

DEA License

Conditional

Required if prescribing controlled substances

Malpractice Insurance

Medical Degree

Medical License

NPI Certificate

Professional Reference

Contact Information

Credentialing

National

1-800-617-4608

Network Enrollment

National

1-800-617-4608

Claims (TX)

National

1-800-600-4441

Provider Relations

National

1-800-617-4608

Need Help?

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