Resources

Opioid information from the Centers for Disease Control and Prevention (CDC)

AmeriHealth Caritas VIP Care (HMO-SNP) values excellent relationships with our health care providers. Together, we can work to improve the quality of and access to care for our members.

Use this section of our site to access the resources you need most, including:

Claims and billing

Claim submission/payment information:

• Electronic Claims Submission
• Payer ID: 88232
• Paper Claims Submission:

AmeriHealth Caritas VIP Care
Claims Processing Department
PO Box 7155
London, KY 40742-7155

• Direct entry claims submission through Change Healthcare's Connect Center
• Video Tutorial – Creating a Claim

• Electronic Funds Transfer/Electronic Remittance Advice Enrollment
• Change Healthcare customer support is available through online chat, or call 1-800-527-8133, option 2 for assistance.

Other claim information:

• Appropriate usage of claims modifiers 25 and 59 (PDF)
• Claims dispute form (PDF)
• Waiver of liability form for nonparticipating provider appeals (PDF)

Contacts

Provider Network Management Account Executive contact information:

• Provider Network Management Account Executive contact information email: PNM_Inquiries@amerihealthcaritasfl.com
• Provider Services 1-833-350-3477
• Email - You can contact us by using our secure form

Credentialing

• Credentialing
• Patient Centered Medical Home Information

Prior Authorization

• Prior Authorization
• Prior Authorization Lookup Tool

Provider Manual

• Provider Manual (PDF)

Quality

• Care for Older Adults (COA) Coding Chart (PDF)
• Care for Older Adults (COA) Provider Form (PDF)
• Clinical Resources
• Controlling Blood Pressure Claims Coding Chart (PDF)
• Diabetes Coding for HEDIS (PDF)
• HEDIS® Incentive Program (PDF)
• Medicare Risk Adjustment Overview and Documentation Guidance (PDF)
• PerformPlus® Gaps in Care Closure Program (PDF)
• Physical Activity in Older Adults (PDF)
• Preventive Services Quick Reference Guide
• Transitional Care Management with Medication Reconciliation Post-Discharge (PDF)
• Urinary Incontinence (PDF)

Training and Education

AmeriHealth Caritas VIP Care (HMO-SNP) provides training and education resources tailored to the needs of our new Medicare providers. We're always striving to offer a variety of different educational opportunities to help our participating providers give quality, expert care to our members.

Our current educational opportunities include:

• Training Modules
• Model of Care training
• Cultural competency training
• Resources for Integrated Care — Resources for dual-eligible programs

Working with AmeriHealth Caritas VIP Care

• Marketing activities and compliance
• Provider Reference Guide (PDF)
• Service area map (PDF)
• Reimbursement Policies

Check back frequently, since we'll be updating this section to include the latest information for our providers. Our participating providers can also call AmeriHealth Caritas VIP Care Provider Services at 1-833-350-3477.

If you are not yet a participating provider, and you would like more information on the benefits of partnering with us, contact Provider Services at 1-833-350-3477.