Begin the Credentialing Process
Practitioner credentialing and the Council for Affordable Quality Healthcare
AmeriHealth Caritas District of Columbia (DC) participates with the Council for Affordable Quality Healthcare (CAQH) to offer providers a Universal Provider Data source that simplifies and streamlines the data collection process for credentialing and re-credentialing.
Through CAQH, providers submit credentialing information to a single repository, via a secure Internet site, to fulfill the credentialing requirements of all health plans participating with CAQH.
There is no charge to providers to participate with CAQH. Providers may submit credentialing information to AmeriHealth Caritas DC via CAQH by:
- Filling out the Provider Data Intake Form (PDF)
- Enabling AmeriHealth Caritas DC to view your information by changing your settings in CAQH
- Faxing your CAQH ID number and completed W-9 (PDF) (PDF) to the AmeriHealth Caritas DC credentialing department at 1-215-863-6369
Want to become a participating dental provider?
Complete the dental practitioner credentialing application (PDF) and return by fax to 215-863-6369 or email to firstname.lastname@example.org.
Paper credentialing for facilities and hospitals
Please complete the forms below to submit your credentialing information to AmeriHealth Caritas DC:
- Follow the AmeriHealth Caritas DC organizational providers credentialing application (PDF) to prepare your credentialing materials for submission
- Credentialing application (PDF)
- W-9 (PDF)
Completing and/or submitting an AmeriHealth Caritas DC credentialing application does not guarantee participation in the AmeriHealth Caritas DC provider network.
Practitioner and organizational provider credentialing rights
After the submission of applications, health care providers have the following rights:
- To review information submitted to support their credentialing applications, with the exception of references, recommendations, and peer-protected information obtained by the plan.
- To correct erroneous information. When information obtained by the Credentialing department varies substantially from information provided by the provider, the Credentialing department will notify the provider to correct the discrepancy.
- To be informed, upon request, of the status of their credentialing or recredentialing applications.
- To be notified within 60 calendar days of the Credentialing Committee or Medical Director review decision.
- To appeal any recredentialing denial within 30 calendar days of receiving written notification of the decision.
- To know that all documentation and other information received for the purpose of credentialing and recredentialing is considered confidential and is stored in a secure location that is only accessed by authorized plan associates.
- To receive notification of these rights.
To request any of the above, providers should contact the AmeriHealth Caritas Corporate Credentialing department at:
Attn: Credentialing Department
200 Stevens Drive
Philadelphia, PA 19113