Clinical resources

Clinical 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 enrollees.
View our clinical guidelines (PDF).

Clinical policies

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 enrollees.
View our clinical policies.

Clinical depression toolkits

The depression toolkits are intended to help primary care clinicians effectively assess, treat and monitor depression in adolescents and adults with this condition.

Children with special needs

AmeriHealth Caritas DC offers provider resources for the treatment of children with special needs (CWSN).
View more information on early intervention and children with special needs.

Preventive health resources

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

EPSDT/HealthCheck

EPSDT/HealthCheck requirements are determined by the District for AmeriHealth Caritas DC enrollees from birth to age 21.
View our EPSDT/HealthCheck requirements.

Other required screenings

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