AmeriHealth Caritas VIP Care, a Medicare Advantage highly integrated dual-eligible special needs plan (HIDE-SNP), is responsible for the credentialing and recredentialing of its provider network. All providers credentialed by AmeriHealth Caritas VIP Care must also be eligible to enroll 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). For more information on how to enroll in CHAMPS, go to MiLogin for Business.

Getting credentialed

AmeriHealth Caritas VIP Care 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.

For providers who prefer a paper credentialing process and to access information for all the required credentialing documents, in addition to those found in a provider's CAQH record, please refer to the following documents:

• Application checklist for facilities (PDF) 
• Provider credentialing and enrollment form (PDF) 
• Maternal infant health program enrollment form (PDF)
• W-9 taxpayer identification request form (PDF) 
• Americans With Disabilities Act (ADA) attestation (PDF)
• Disclosure of ownership form (PDF)

Completed enrollment forms should be submitted via the following method:

Email: mimmppnm@amerihealthcaritas.com

If you have questions, need additional information, would like to review the provider contract, or would like to submit the completed enrollment forms directly to the AmeriHealth Caritas VIP Care Provider Network Account Executive, please contact:

Angela Milton, Provider Network Account Executive
Email: mimmppnm@amerihealthcaritas.com
Phone: 1-248-663-7945
Fax: 1-248-663-7955

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