Professional Provider CredentialingCredentialing and recredentialing made easierAny professional provider interested in participating in our network must complete and return a credentialing application kit. You can simplify this process by using the Council for Affordable Quality Healthcare’s (CAQH) online credentialing application: CAQH ProView®. Learn more about our credentialing criteria. Save TimeCompleting the credentialing process can take hours if you’re filling out paper forms. This is especially true if your practice contracts with multiple health plans. The CAQH ProView online application minimizes the time it will take to complete this administrative work by eliminating the need to fill out multiple, redundant, and time-consuming forms. Save MoneyThe CAQH ProView online application is entirely free to providers, and helps practices save money on administrative resources. Keep Your Information CurrentKeeping practice information up-to-date isn’t just important for credentialing purposes, it’s important for health plan records and directories too. The CAQH ProView, online application makes it quick and easy for you to stay current by allowing you to update only the information that needs to change. There’s no need to resubmit information that should stay the same. The CAQH ProView electronic credentialing application is free to providers and available on the CAQH ProView website. Behavioral HealthBehavioral health providers must be contracted with Magellan Healthcare, Inc., an independent company. Interested behavioral health providers can contact Magellan by selecting the "Join the Network" link or by contacting their Magellan Provider Services Line at 1-800-788-4005 for assistance. Network AreaPennsylvania & DelawareIf you have a primary practice address in Pennsylvania or Delaware and would like to join our network(s), you must notify AmeriHealth by submitting a Practitioner Participation Form. Important credentialing notes
New accreditation requirementsOffice-based varicose vein proceduresEffective June 1, 2019, all network offices that perform varicose vein procedures will need to obtain office-level accreditation from the Intersocietal Accreditation Commission (IAC) Vein Center. All network offices that plan to perform or would like to continue performing varicose vein procedures must appear on the IAC-approved list for Vein Center Accreditation by June 1, 2019, indicating that they have met the IAC standards. Those offices who fail to meet the requirements by this date will no longer be reimbursed for varicose vein procedures. To learn more about the IAC Vein Center accreditation program, please visit the IAC website or call 1-800-838-2110. If you have additional questions, please email us at qualitymanagement@amerihealth.com. Be sure to include your name, contact number, and provider ID number in your email. Closed NetworksThe following professional provider networks have limitations to participation: PathologyThe pathology provider network is closed for new office-based pathology providers in the AmeriHealth service area (i.e., participating counties in Pennsylvania, Delaware, and Maryland) except when the pathologist meets the following condition:
Note: Pathologists cannot be added to participating non-pathology practices. PodiatryThe podiatry network is closed to new providers except when the provider meets one or more of the following conditions:
ChiropracticThe chiropractic network is closed to new providers in Pennsylvania and Delaware except when the provider meets one of the following conditions:
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