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Guidelines and policies

Practice guidelines

These guidelines are comprised of evidence-based research and professional standards; they are intended to guide providers in the treatment of AmeriHealth Caritas DC members.
View our clinical guidelines.


AmeriHealth Caritas DC utilizes InterQual Criteria to guide medical necessity determinations. Requests that are not addressed by, or do not meet, the medical necessity guidelines are referred to the Medical Director for a decision.  During review, the Medical Director utilizes these clinical policies, which are intended to provide the most comprehensive health solutions for our AmeriHealth Caritas DC members.
View our clinical policies.

Preventive health resources

AmeriHealth Caritas DC wants to partner with you to prevent member illnesses by delivering the best preventive care. View our preventive care resources

Other required screenings

Other screenings may be required for certain AmeriHealth Caritas DC members, according to District guidelines.
View required screenings guidelines