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Providers

Thank you for all that you do to help our members get well and stay healthy

Continuity of care

  • To help maintain continuity of care for new members, AmeriHealth Caritas District of Columbia (DC) has waived prior authorization requirements for new members' outpatient procedures and treatments through October 31, 2017. Inpatient admissions will continue to require notification and authorization consistent with existing AmeriHealth Caritas DC policies and procedures.
  • At AmeriHealth Caritas DC, referrals are not required for specialist visits, so your patients can see any provider in the AmeriHealth Caritas DC network without any special processes or paperwork.
  • If you have any questions, please contact your Provider Network Management Account Executive or Provider Services at 202-408-2237. Dental providers, please call 1-855-609-5170.
  • If you need help or have questions related to the prior authorization process, please contact our Utilization Management department at 1-888-605-4807.

Open enrollment

  • Open enrollment begins October 1, 2017, and continues through December 31, 2017, for all Medicaid and Alliance members enrolled with a managed care organization (MCO).
  • During open enrollment, all Medicaid and Alliance members are free to stay with their current MCO or choose a new MCO. They can switch as often as they would like until December 31, 2017.
  • If a member would like to keep their current health plan and stay with their current MCO, they do not have to do anything.
  • If a member would like to switch to another health plan, they need to contact DC Healthy Families at 1-800-620-7802.

NaviNet provider portal

Submit referrals and claims and view member eligibility and benefits.

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Will you Let Us Know?

Use the Let Us Know program to partner with AmeriHealth Caritas District of Columbia to better engage with and manage the health care needs of our members — your patients. The program helps connect members with resources, such as the Rapid Response and Outreach Team and Care Management.

Check out our provider orientation and quick reference materials for easy access to the information you need.

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Important contact information

  • Provider Account Executives (PDF)
  • Provider Services: 202-408-2237 or 1-888-656-2383
  • Provider Services fax: 202-408-1277
  • Utilization Management: 1-888-605-4807
  • Utilization Management fax: 1-877-759-6216
  • Credentialing: 1-877-759-6186