Claims and billing

• Electronic Claims Submission
• Payer ID: 31481
• Paper claims submission

   AmeriHealth Caritas VIP Care
   Claims Processing Department
   P.O. Box 7436
   London, KY 40742-7436

• Direct entry claims submission through Change Healthcare's Connect Center 
• Submit a 275 claim attachement.
• Change Healthcare customer support is available through online chat, or call 1-800-527-8133, option 2, for assistance.
• Electronic Funds Transfer/Electronic Remittance Advice/Virtual Credit Card Enrollment

Other claim information:

• Appropriate usage of claims modifiers 25 and 59 (PDF)
• CES explanation codes (PDF)
• Claim dispute form (PDF)
• Common Errors for Claims Submissions (PDF)
• Edifecs FAQ Resource Tool (PDF)
• Reimbursement Policies
• Waiver of liability form for nonparticipating provider appeals (PDF)

Contacts

• Provider Network Management Account Executive contact information:
• Provider Services: 1-833-852-4767

Quality

• Care for the Older Adults (COA) coding chart (PDF)
• Care for Older Adults (COA) form (PDF)
• Clinical resources
• Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Health Outcomes Survey (HOS) information (PDF)
• Controlling Blood Pressure Claims Coding Chart (PDF)
• Diabetes Coding for HEDIS (PDF)
• HEDIS Incentive Program (PDF)
• Member wellness brochure: Live Well at Any Age — Seven tips to help you live a healthy, happy life as you grow older (PDF)
• Medicare risk adjustment overview and documentation guidance (PDF)
• Preventive Services Quick Reference Guide
• Promoting physical activity notice (PDF)
• Transitional care management with medication reconciliation post-discharge notice (PDF)
• Urinary incontinence notice (PDF)

Training and education

AmeriHealth Caritas VIP Care (HMO-SNP) provides training and education resources tailored to the needs of our new Medicare providers. We're always striving to offer a variety of different learning opportunities to help our participating providers give quality, expert care to our members.

Our current learning opportunities include:

• Training modules
• Model of care training 
• Cultural competency training
• Fraud, waste, and abuse
• Resources for Integrated Care Available for Health Plans and Providers (resources for dual-eligible individuals)

Working with AmeriHealth Caritas VIP Care

• Marketing activities and compliance
• Provider Reference Guide (PDF)
• Service area map (PDF)

Check back frequently, since we'll be updating this section to include the latest information for our providers. Our participating providers can also call AmeriHealth Caritas VIP Care Provider Services at 1-833-562-4767.

If you are not yet a participating provider, and you would like more information on the benefits of partnering with us, contact Provider Services at 1-833-562-4767.

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