Let Us Know Program

AmeriHealth Caritas District of Columbia (DC) is here to help you engage enrollees in their health and well-being. Let us know when our help is needed.

When enrollees need assistance managing their health, we can help!

Clinical resources

Use our Enrollee Intervention Request Form (PDF) to let our Rapid Response and Outreach Team (RROT) know of enrollees who we can assist with issues, such as:

  • Missing an appointment
  • Behavioral health assistance
  • Medication noncompliance
  • Care management engagement
  • Developmental screening issues
  • Emergency room misutilization
  • Limited to no knowledge of plan benefits
  • Needs related to social determinants of health
  • Tobacco cessation referral

For questions, call the RROT at 1-877-759-6224.

Look up enrollee care gaps

You can view enrollee care gap information using our NaviNet provider portal to determine when an enrollee is overdue for preventive care services or may be underutilizing disease-specific medication. There are two ways to view enrollee care gap information and access a Care Gap Worksheet in NaviNet:

  1. Report Inquiry. You may view a Care Gap Worksheet for a specific enrollee by using the Report Inquiry option from the transaction menu.
  2. Pop-up alert. If an enrollee has a care gap, an alert message will appear on your screen when checking their eligibility and benefits. You can click on the alert to access a Care Gap Worksheet for that enrollee.

You can use the Care Gap Worksheet to request that our RROT contact the enrollee.

Log in to NaviNet to view enrollee care gaps. Not registered? Sign up now.
Learn more about all the services our provider portal offers by viewing our NaviNet resources webpage.

Refer to Case Management

AmeriHealth Caritas DC offers care management programs to assist enrollees with their specific health needs. Learn about these programs on our website or use our Enrollee Intervention Request Form (PDF) to refer an enrollee to a program. You may also call the RROT at 1-877-759-6224 for additional assistance.

Bright Start® pregnancy program

Bright Start helps pregnant enrollees have healthy pregnancies and prepare for the arrival of their babies. Learn about Bright Start on our website or use our Enrollee Intervention Request Form (PDF) to refer an enrollee to the program. You may also call the Bright Start team at 1-877-759-6883 for additional assistance.

Events and programs

Learn more about:

For questions or more information, call the Community Outreach Solutions team at 202-216-2318.

Other provider services

  • 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
  • Provider Account Executives contact list (PDF)

Enrollment verification

To verify that a patient is an AmeriHealth Caritas DC enrollee, log in to NaviNet provider portal. Not registered for NaviNet? Sign up now.

Providers