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Credentialing

Become a participating provider

In order to provide services to AmeriHealth Caritas Pennsylvania (PA) Community Health Choices (CHC) Participants as a participating provider, practitioners must:

  1. Be credentialed by AmeriHealth Caritas PA CHC (1-800-642-3510, option 2).
  2. Sign a Participating Provider Agreement (contract) 1-866-546-7972.

Contracting

If you are not currently contracted with AmeriHealth Caritas PA CHC and are not joining a group already in our network, please call 1-866-546-7972 to discuss obtaining the appropriate AmeriHealth Caritas Provider Agreement.

The credentialing process and contracting process can occur simultaneously.

To comply with provisions of the Affordable Care Act (ACA) regarding enrollment and screening of providers (Code of Federal Regulations: 42CFR, §455.410), all providers MUST be enrolled in the Pennsylvania State Medicaid program before a payment of a Medicaid claim can be made. This applies to non-participating out-of-state providers as well.

If you are not yet enrolled in the Pennsylvania State Medicaid program, enroll today.

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Credentialing

AmeriHealth Caritas PA CHC maintains and adheres to all applicable state and federal standards and regulations, Department of Human Services (DHS) requirements, and accreditation requirements governing credentialing and re-credentialing functions. Call 1-800-642-3510, option 2 for more information.

The following types of physical health practitioners require credentialing and re-credentialing:

  • Allied Health Providers (Physical Therapists, Occupational Therapists, and Speech Therapists).
  • Audiologist.
  • Certified Nurse Midwife.
  • Certified Registered Nurse Practitioner.
  • Chiropractor.
  • Dentist.
  • Oral Surgeon.
  • Physicians (DOs and MDs).
  • Podiatrist.
  • Registered Dietician.

The following types of long-term services and support providers require credentialing and re-credentialing:

  • Habilitative.
  • Rehabilitative.
  • Home Care.
  • Social Services.
  • Health Care Facility.
  • Assisted Living Community.
  • Medical Equipment Supplier/Contractor.
  • Transportation.
  • Other Residential settings.

Select a credentialing process

Additional information