Managed Care Organization

How to Get Credentialed with AmeriHealth Caritas in Pennsylvania

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

Pennsylvania-Specific Requirements

AmeriHealth Caritas Pennsylvania participates in the HealthChoices Physical Health managed care program. Providers must first enroll with Pennsylvania Medicaid through PROMISe, then apply to AmeriHealth Caritas via CAQH ProView. Active Pennsylvania medical license and NPI are required. Service areas include the Southeast HealthChoices zone and other regions. Behavioral health services are carved out to separate Behavioral Health MCOs in each county or zone.

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 Pennsylvania.

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

Quick Links

AmeriHealth Caritas Website Provider Portal Join Network

Need Help?

Let PayerReady handle your AmeriHealth Caritas enrollment in Pennsylvania.

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AmeriHealth Caritas in Other States

District Of Columbia Delaware Florida Georgia Louisiana Michigan North Carolina New Hampshire New Jersey Ohio

Other Payers in Pennsylvania

Aetna UnitedHealthcare Cigna Healthcare Anthem / Elevance Health Humana Centene Corporation Molina Healthcare Highmark Blue Cross Blue Shield (Western PA) Independence Blue Cross Pennsylvania Medical Assistance
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