AmeriHealth requires credentialing of all physicians and all other types of health care providers who provide services to AmeriHealth members and who are permitted to practice independently under applicable state law. All providers must be credentialed and contracted before they are allowed to provide care to AmeriHealth members.*

Information on our network credentialing process and credentialing criteria can be found on the credentialing webpages for AmeriHealth New Jersey and AmeriHealth Pennsylvania or in the Quality Management section of the Provider Manual for Participating Professional Providers.

Submitting credentialing applications

To ensure that credentialing applications are managed in a timely manner, it is important for providers to adhere to the processes outlined below for provider credentialing.

All professional providers interested in becoming a participating provider must apply for credentialing by completing the online Practitioner Participation Form for AmeriHealth New Jersey or AmeriHealth Pennsylvania.

Providers interested in becoming credentialed in New Jersey are strongly encouraged to first complete the Council for Affordable Quality Healthcare’s (CAQH) online credentialing application: CAQH ProView^®. However, AmeriHealth New Jersey will accept the New Jersey Universal Physician Credentialing application. To become credentialed in Pennsylvania, providers are required to also complete CAQH ProView.

If your practice contracts with multiple health plans, the CAQH ProView online application minimizes the administrative work needed to fill out multiple, redundant, and time-consuming forms.

If you have already been credentialed by AmeriHealth, there is no need to resubmit a Practitioner Participation Form or a CAQH ProView credentialing application. 

Submitting requests not related to credentialing

The Practitioner Participation Form is used strictly for credentialing applications. If you need to make changes to your basic provider information (e.g., updating names, addresses, office hours, contact information associated with your practice), please use our Demographic Maintenance Guide for AmeriHealth New Jersey or AmeriHealth Pennsylvania. 

Learn more

If you have additional questions on the content of this article, please email our Provider Communications team at providercommunications@amerihealth.com.

*Behavioral health providers must be credentialed by and contracted with Magellan Healthcare, Inc. Interested behavioral health providers can contact Magellan by selecting the “Join the Network” link or by contacting their Magellan Provider Services Line at 1-800-788-4005 for assistance.

Magellan Healthcare, Inc. manages mental health and substance abuse benefits for most AmeriHealth members.