AmeriHealth Caritas Ohio
Under a Medicaid Provider Agreement with the Ohio Department of Medicaid (ODM), AmeriHealth Caritas Ohio will serve Medicaid beneficiaries across the state, starting July 1, 2022.
Right now, AmeriHealth Caritas Ohio is developing a network of hospital, physician, ancillary, behavioral health, dental, and vision providers. We want to work with dedicated providers like you. Opens a new windowLearn more about our commitment to participating providers (PDF).
Join today! We want your name and practice information to appear in our Provider Directory at Open Enrollment for Ohio’s Next Generation Medicaid Managed Care health plans in Spring 2022. Together we can improve the lives of Medicaid beneficiaries in Ohio and achieve ODM’s vision of a seamless experience for Medicaid health plan members.
Join AmeriHealth Caritas Ohio
To request a Provider Agreement, please complete a Provider Contract Inquiry Form (PDF) Opens a new window and return by email to firstname.lastname@example.org. Contact us by phone at 1-833-296-2259 if you have any questions.
We are working toward completion of our network by February 2022. Join today!
Please complete, sign, and return the following documents to support the execution of your provider contract with AmeriHealth Caritas Ohio. You may complete all documents in a digital format.
- ODM Medicaid Addendum (PDF): This supplements your base provider contract with AmeriHealth Caritas Ohio and runs concurrently with the terms of the base provider contract. The Addendum is limited to the terms and conditions governing the provision of, and payment for, health services provided to Medicaid members.
- ODM Attachments: Choose the most appropriate form for your provider type:
- Attachment A (PDF), for physicians, is needed to identify your capacity and service location.
- Attachment B (PDF), for facilities, is only required for hospital providers to identify services or religious/moral objections.
- Attachment C (PDF), for all providers, is only required when the contract between the managed care entity and the provider includes fewer specialties than the provider identified in the Provider Network Management (PNM) system.
- Provider Data Intake Form for practitioners (PDF)
- Behavioral Health Data Intake Form (PDF)
- Hospital/Facility Data Intake Form (PDF)
- Ancillary Data Intake Form (PDF)
As a reminder, please pre-register for ODM's Provider Network Management (PNM) module and also log in to the Ohio Medicaid Information Technology System (MITS) Provider Portal to update your demographic information.
Send us your completed forms through the method most convenient to you:
- Email: Return your forms to your Account Executive at email@example.com or to Provider Network Operations at firstname.lastname@example.org.
- Fax: 1-844-933-0285.
Corporate Provider Network Operations
P.O. Box 406
Essington, PA 19029-0406
Value-added benefits for members
In addition to a focus on supporting our network providers, qualifying AmeriHealth Caritas Ohio members may also get enhanced benefits like:
- Mission GED® — Adult members can receive coaching and vouchers to take a high school equivalency exam at no cost.
- WW® (formerly Weight Watchers) online membership — Members ages 15 – 64 can get WW membership at no cost for six months.
- CARE Card — Earn rewards on a reloadable gift card by doing things that help you stay healthy.
- Living Beyond Pain — Pain management program to include alternative treatment options.
- Food as Medicine — Up to two meals per day, for seven days, at no cost for qualifying members discharged from a hospital.
- Vision care — One additional eye exam every 12 months for members ages 21 – 59 diagnosed with diabetes.
- Dental care — One additional cleaning and exam per calendar year for members 21 and over (some restrictions and limitations apply).
- Transportation benefit — Qualifying members will receive transportation benefits for up to 30 nonemergency, nonmedical one-way local trips per year.
- Foster Care Transition — Care package valued up to $50 and specialized support for members leaving foster care.
- Boys & Girls Club— Membership, at participating clubs, for qualified members under age 19.
Want to learn more? Our Introduction for Ohio Providers (PDF) includes:
- A more in-depth look at the advantages of joining our growing provider network.
- Expanded explanations of our programs and services.
- Ways you can contact us.