Join Our Provider Network
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.
- Provider overview (PDF)
- ADA attestation (PDF)
- Dual Eligible Demonstration Program Compliance Attestation (PDF)
- Explanation of Dual Eligible Demonstration Compliance Attestation (PDF)
- Application Checklist for Facilities (PDF)
- Facility Credentialing Application (PDF) (required)
- Practitioner Credentialing Application (PDF) (required)
- W-9 Taxpayer Identification Request Form (PDF) (required)
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 email@example.com.
Completed enrollment forms should be submitted via the following methods:
Mail: AmeriHealth Caritas VIP Care Plus
Attn: Provider Network Management
4000 Town Center
Southfield, MI 48075
Completed enrollment forms can also be sent directly to your AmeriHealth Caritas VIP Care Plus Provider Network Management Account Executive:
Practitioner and organizational provider credentialing rights
After the submission of 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:
Attn: Credentialing Department
200 Stevens Drive
Philadelphia, PA 19113