If you are not registered with the Council for Affordable Quality Healthcare (CAQH) and would prefer to join the AmeriHealth Caritas Pennsylvania Community HealthChoices provider network via our paper process, complete and return the documents linked below. If you have any questions, please call 1-800-642-3510, option 2.
* CAQH credentialing does not apply to HCBS and LTSS providers. HCBS and LTSS providers should complete our paper application process.
HCBS and LTSS providers
HCBS and LTSS provider requests for a provider contract can be sent to: CHCProviders@amerihealthcaritas.com. Please include a copy of your W-9 (PDF), counties that you cover, and services that you provide. A completed contract is required in order to start the credentialing process.
- Application for home- and community-based services and LTSS providers (PDF)
- Application checklist for non-traditional organizational providers (PDF)
Physical health practitioners
- Credentialing application (PDF) (PA Standard Application)
- Application checklist for practitioners (PDF)
- Application for organizational providers (PDF)
- Application checklist for organizational providers (PDF)
Completing and/or submitting the AmeriHealth Caritas PA CHC credentialing application does not guarantee participation in the AmeriHealth Caritas PA CHC provider network.
Note: If you are joining an existing AmeriHealth Caritas PA CHC participating group or health care facility and you would like to become a participating provider, please use the credentialing application (PDF).