Join AmeriHealth Caritas Idaho

Thank you for your interest in joining the AmeriHealth Caritas Idaho provider network. To begin the contracting process, please complete the following items:

1. Contract Inquiry Form
   Please complete the Contract Inquiry Form (PDF).
2. Letter of Intent
   Please complete the Letter of Intent (PDF), including the Provider Information Sheet on page 2.
3. Request for Taxpayer Identification Number and Certification (W-9)
   Please complete the W-9 (PDF).

When finished, return all documents using one of the following methods:

• Email: providerrecruitmentID@amerihealthcaritas.com
• Fax: 1-877-234-4275

After you submit the documents, someone from our provider network team will follow up with you to answer your questions and provide additional information as needed. To reach our provider network team, contact us at 1-855-613-0420 or providerrecruitmentID@amerihealthcaritas.com.