Join Our Provider Network — Credentialing
Our goal is to establish an efficient, transparent relationship with all of our providers, one that helps your business and your patients stay healthy. As your partner in care, we'll deliver the tools you need to help you improve the lives of Michigan's dual-eligible members residing in Wayne and Macomb counties.
AmeriHealth Caritas VIP Care Plus (Medicare-Medicaid Plan) is responsible for the credentialing and recredentialing of its provider network. All providers credentialed by AmeriHealth Caritas VIP Care Plus must also be enrolled with the Medicare program and, as such, must agree to comply with all pertinent Medicare regulations.
All providers must also be registered with Michigan's web-based Medicaid claims payment system, known as the Community Health Automated Medicaid Processing System (CHAMPS). Effective January 1, 2018, Medicaid claims submitted by providers who have not fully completed provider enrollment in CHAMPS will deny or not appear on a remittance advice. For more information on how to enroll in CHAMPS, go to milogintp.michigan.gov.
Getting credentialed
AmeriHealth Caritas VIP Care Plus works with the Council for Affordable Quality Healthcare (CAQH) to offer providers a universal provider datasource that simplifies and streamlines the data collection process for credentialing and recredentialing.
To access information for all the required credentialing documents, in addition to those found in a provider's CAQH record — or for providers who prefer a paper credentialing process — please visit Join our provider network or contact your local Account Executive.
- Application Checklist for Facilities (PDF)
- Facility Credentialing Application (PDF) (required)
- Practitioner Credentialing Application (PDF) (required)
- W-9 Taxpayer Identification Request Form (PDF) (required)
- ADA attestation (PDF)
- Dual Eligible Demonstration Program Compliance Attestation (PDF)
- Explanation of Dual Eligible Demonstration Compliance Attestation (PDF)
Additional credentialing information
For a complete list of the types of providers and facilities that AmeriHealth VIP Care Plus (Medicare-Medicaid Plan) is responsible for credentialing, see the Provider Manual (PDF).
Contact information
If you have questions, need additional information, or would like to review the provider contract, please contact your AmeriHealth Caritas VIP Care Plus Provider Network Management Account Executive at 1-248-663-7945 or at mimmppnm@amerihealthcaritas.com.
Completed enrollment forms should be submitted via the following method:
Email: mimmppnm@amerihealthcaritas.com
Completed enrollment forms can also be sent directly to your AmeriHealth Caritas VIP Care Plus Account Executive:
Angela Milton, Account Executive
Email: mimmppnm@amerihealthcaritas.com
Phone: 1-248-663-7945
Fax: 1-248-663-7955
Provider and organizational provider credentialing rights
After submitting applications, health care providers have the following rights:
- To review information submitted to support their credentialing applications, with the exception of references, recommendations, and peer-protected information obtained by the plan.
- To correct erroneous information. When information obtained by the Credentialing department varies substantially from information provided by the provider, the Credentialing department will notify the provider to correct the discrepancy.
- To be informed, upon request, of the status of their credentialing or recredentialing applications.
- To be notified within 60 calendar days of the Credentialing Committee or Medical Director review decision.
- To appeal any recredentialing denial within 30 calendar days of receiving written notification of the decision.
- To know that all documentation and other information received for the purpose of credentialing and recredentialing is considered confidential and is stored in a secure location that is only accessed by authorized plan associates.
- To receive notification of these rights.
To request any of the above, providers should contact the AmeriHealth Caritas Corporate Credentialing department at:
AmeriHealth Caritas
Attn: Credentialing Department
200 Stevens Drive
Philadelphia, PA 19113