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.
  • 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.