How to Get Credentialed with AmeriHealth Caritas in Pennsylvania
Quick Overview
Timeline
30 - 90 days
CAQH
Required
Re-credentialing
Every 3 year(s)
Delegated
Yes
Pennsylvania-Specific Requirements
Step-by-Step Enrollment Process
Gather Required Documents
Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for Pennsylvania.
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.
Submit Your Application
Submit your completed enrollment package to AmeriHealth Caritas. You can start the process at their enrollment portal.
Track & Follow Up
Credentialing typically takes 30-90 days. Monitor your application status and respond promptly to requests for additional information.
Free Consultation
Need help enrolling with AmeriHealth Caritas?
Our specialists handle the entire AmeriHealth Caritas enrollment process: applications, follow-ups, and approvals in Pennsylvania.
Required Documents Checklist
Board Certification
ConditionalRequired if board certified; highly recommended
CV/Resume
DEA License
ConditionalRequired if prescribing controlled substances
Malpractice Insurance
Medical Degree
Medical License
NPI Certificate
Professional Reference
Free Tools for Your AmeriHealth Caritas Enrollment
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Key Credentialing Terms
- Capitation
- A payment model where a payer pays a provider a fixed amount per member per month regardless of whether the member recei...
- CAQH
- The Council for Affordable Quality Health Care, an organization that maintains a universal provider database (CAQH ProVi...
- Credentialing
- The process of verifying a healthcare provider's qualifications, training, licensure, and professional background to ens...
- Effective Date
- The date on which a provider's enrollment or network participation becomes active, allowing them to begin billing a paye...
- Managed Care
- A healthcare delivery system organized to manage cost, utilization, and quality through techniques such as provider netw...
- Network Adequacy
- The requirement that a health plan's provider network has enough providers in each specialty and geographic area to give...
- NPI
- The National Provider Identifier is a unique 10-digit identification number issued by CMS to healthcare providers, requi...
- Primary Source Verification
- The process of verifying a provider's credentials directly from the original issuing source, such as medical schools, li...
Credentialing Checklist
Make sure you have everything ready before applying to AmeriHealth Caritas.
View Physician Credentialing Checklist →Contact Information
Credentialing
National1-800-617-4608
Network Enrollment
National1-800-617-4608
Claims (TX)
National1-800-600-4441
Provider Relations
National1-800-617-4608
Quick Links
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Reviewed by the PayerReady Credentialing Team
Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.