Provider

Change Healthcare System Interruption

Change Healthcare, our electronic data interchange (EDI) clearinghouse for claims and payment cycle management, continues to address their network interruption related to a security incident. Below are updates for our systems and processes:

  • Electronic claims submission: We have established a connection with Availity to receive electronic claims. If you or your clearinghouse do not currently use Availity to submit claims, you may register at: https://www.availity.com/Essentials-Portal-Registration. You will find registration options for Healthcare and Atypical Provider, so please choose the one that aligns with your business. For registration process assistance and other resources, access the training site link on the Availity registration page.
  • Manual claims submission: We have established a direct claims entry process through PCH Global. To submit claims directly, please go to https://pchhealth.global and click the Sign-Up link in the upper right-hand corner to register. Complete the registration process and log into your account. You will be asked how you heard about PCH Global; select Payer, then AmeriHealth. Access your profile by clicking on Manage User and then My Profile. You will need to complete all the profile information. When you go to the Subscription Details screen, select the More option on the right-hand side to see how to enter the promo code Exela-EDI.
  • When you are ready to submit claims, use the following information to search for our payer information:

    1. Payer name: AmeriHealth – AmeriHealth VIP Care Florida DSNP
    2. PO Box: 7155

     For a detailed walk through of the registration process, refer to the PCH Global Registration manual, found on the PCH Global website in the Resource Menu.

  • Prior authorization submission and processing: The prior authorization systems continue to operate normally.
  • Eligibility verification, claim status inquiry, and authorization inquiry: These capabilities continue to be available via NaviNet. If you do not have access to NaviNet provider portal, please visit https://register.navinet.net/ to sign up.

This interruption continues to have downstream impacts to our plan and the provider community, including:

  • Our ability to:
    • Remit claim payments and remittance advice, both electronic and paper
  • Providers’ ability to:
    • Submit claims directly to Change Healthcare via NaviNet and ConnectCenter
    • Access and view electronic remittance advice in NaviNet

Please note, in the interim our Provider Services Department will not be able to assist with the processing of your payments any sooner. If you have other questions, you may contact Provider Services at 1-833-350-3477.

We thank you for your partnership and will continue to provide updates as we work to resolve the downstream impacts of Change Healthcare’s service interruption.

AmeriHealth Caritas is pleased to welcome our AmeriHealth Caritas VIP Care participating providers. As an AmeriHealth Caritas VIP Care provider, you are a part of a dedicated network that is ready to meet our members' health care needs. As partners in care, we'll work with you to ensure that our members receive access to the quality health care they need and deserve, through a plan which features:

  • A coordinated care approach
  • Leading technology solutions
  • Innovative community outreach programs that offer better health outcomes to our members

Our robust network is designed to provide our members with integrated care. You will find other committed providers like you in the directories below:

If you notice any errors in the directory, please fax, on practice letterhead, the information as it should appear, to the attention of Provider Services at 1-833-350-3477, Monday through Friday, 8 a.m. – 8 p.m., from April 1 to September 30; or seven days a week, 8 a.m. – 8 p.m., from October 1 to March 31.

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