Non-participating providers

Thanks for your interest in AmeriHealth Caritas District of Columbia. Being a non-participating or out-of-network provider means you do not have a contract with AmeriHealth Caritas DC to provide covered services for our enrollees. If your practice or facility is in or near the DC area, please consider contracting with us to become a participating provider.

Authorization to render services

In certain circumstances, non-participating providers may render covered services to AmeriHealth Caritas DC enrollees with prior authorization from the health plan. You can request authorization to provide such services by:

  • Calling 1-202-408-4823 or 1-800-408-7510
  • Faxing a completed Prior Authorization Form  to 1-202-408-1031 or 1-877-759-6216

The Utilization Management hours of operation are 8 a.m. to 5:30 p.m., Monday through Friday.

Billing AmeriHealth Caritas DC as a non-participating provider

Occasionally, an out-of-state or other non-participating provider renders services to an AmeriHealth Caritas DC  during an emergency or with prior authorization. In these cases, non-participating providers must follow the steps below to bill AmeriHealth Caritas DC for services rendered:

Providers