Amerihealth dc provider phone number. Customer service hours are Monday – Friday, 8 a. Consistent eligibility verification and clear communication Dear Provider, On January 1, 2026, AmeriHealth Caritas District of Columbia (DC) launched the Healthy DC Plan for enrollees. Important contact information for AmeriHealth providers. . Contact AmeriHealth We’re here to help. If you have questions about this communication, please contact Dental Provider Services at 1-855-609-5170. 5400). 0097. For additional program details, please visit: AmeriHealth Caritas District of Columbia has contracted with PalmQuest to assist with the annual medical record review process. Enrollees should call us before their provider appointments if they need interpretation Walk-in hours: Monday - Friday: 8:15 a. Use the contact information below to get in touch. Get qualified as an in-network provider and see how we help you through innovation and referrals. PalmQuest is required to comply with Health Insurance Portability and Accountability Act (HIPAA) privacy requirements throughout the retrieval process and utilizes specialists trained in medical record retrieval for HEDIS, the Centers for Medicare & Medicaid Services An MUE represents the maximum units of service allowed for the same service or supply, reported by a CPT or HCPCS code, on the same date of service by the same provider. This policy provides guidance for the submission and reimbursement of hemodialysis services furnished to enrollees with End-Stage Renal Disease (ESRD) when provided in a facility setting or in the patient’s home. Use the links below to find a doctor, hospital or other AmeriHealth Caritas District of Columbia participating provider. As of March 1, 2026, the District of Columbia Department of Healthcare Finance (DHCF) transitioned to a new Medicaid Management Information System (MMIS) and moved from Conduent to Gainwell as its fiscal agent. View our medical and pharmacy policies, clinical practice guidelines, and details about preapproval for services. Requests for authorization services should be entered through PEAR Practice Management on the Provider Engagement, Analytics & Reporting (PEAR) portal. AmeriHealth Caritas DC can be contacted via phone at (800) 408-7511 for pricing, hours and directions. – 6 p. Phone For the most direct service, call the number on the back of your AmeriHealth ID card. Interpreter services do not cost you any money. Sincerely, Nathan Fletcher, DDS Dental Director AmeriHealth Caritas DC Dear Provider, Effective February 1, 2026, AmeriHealth Caritas District of Columbia (DC) will implement updates to its Hemodialysis Reimbursement Policy (RPC. Extended evening and weekend hours may vary. Find important forms, phone numbers, email addresses, mailing addresses, and more. For Medicaid enrollees, please call Enrollee Services at 202-408-4720 or toll free at 1-800-408-7511 to get interpretation services. The information below includes key contact numbers, addresses, and frequently asked questions to support care delivery and claims processing for Healthy DC Plan enrollees. Additional details for scoring the condition can be found in the HLD Index Scoring Instructions included at the bottom of the form. - 4:45 p. AmeriHealth Caritas DC is located at 1250 Maryland Ave SW in Washington, District of Columbia 20024. AmeriHealth Caritas is proud to offer award-winning health plans, but we also work to treat all aspects of our members’ lives. Log inOpens a new windowRegisterOpens a new window Member and provider services For information about your AmeriHealth Caritas health plan or product, choose your health plan from the list below and see how to get in touch. AmeriHealth Caritas DC will provide enrollees oral interpretation services if they need them, including at the hospital. Our language line service has representatives who speak languages other than English. From health outreach to opioid prevention to job training and more, our approach to managed care encompasses the whole person. Find the care our enrollees need Searchable provider directory Provider directory - machine readable (TXT) Medicaid provider directory - printable (PDF) Medicaid behavioral health provider directory - printable (PDF) 6 Best AmeriHealth In-Home Respite Care Providers near Washington, DC 20001 If you have any questions or want to know more about the survey, please call Enrollee Services at 202-408-4720 (TTY 1-800-408-7511), 24 hours a day, seven days a week. If you do not speak English, we can help you. This FAQ outlines key information on eligibility, ID numbers, authorizations, and benefit differences from Medicaid. Submit referrals and claims and view enrollee eligibility and benefits. As AmeriHealth Caritas DC enrollees transition from Medicaid to the Healthy DC Plan, providers play an important role in helping ensure accurate eligibility verification and clear communication about covered benefits. m. The policy AmeriHealth offers affordable health coverage to individuals, families, and businesses in New Jersey and select Pennsylvania-based employer groups. If you are a consumer member, call 1-844-937-2448. Additional information related to a prior authorization request or appeal AmeriHealth Caritas District of Columbia's Compliance Hotline: 1-800-575-0417 Hours: 24 hours a day, seven days a week To report fraud Enrollee Services: 1-202-408-4720 or 1-866-408-7511 TTY/TDD: 1-202-216-9885 or 1 Use the tools below to find a doctor, hospital or other AmeriHealth Caritas District of Columbia participating provider. Access to the Gainwell Provider Web Portal requires Trading Partner registration. AmeriHealth Caritas DC follows the Centers for Medicare & Medicaid Services (CMS) Medicaid National Correct Coding Initiative (NCCI) MUE program when adjudicating claims. hosdx nywr jmgdpn uog ssa gkgsjf ofbfzla mikl kiflkk lfqj