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Our policy on credentialing providers in training

April 6, 2017

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Attention! There is an updated version of this communication, Update: Our policy on credentialing providers still in training.

As a reminder, AmeriHealth requires credentialing and contracting of all providers who provide services to our members. It is our policy to not credential providers currently in training. In order to be credentialed with AmeriHealth, providers must have completed all residency/fellowship training and must not be in an active residency/fellowship training program.

Any professional provider interested in participating in our network must complete and return a credentialing application kit. You can simplify this process by using the Council for Affordable Quality Healthcare?s (CAQH) online credentialing application: CAQH ProViewTM.

A completed, signed, and dated application includes, but is not limited to:

  • work history for immediate previous five years from the date the application was signed, including month and year, with a written explanation of gaps greater than six months;
  • education and training completed (e.g., medical school, residency training, and fellowships);
  • statement of chemical dependency or substance abuse;
  • loss or limitation of license or felony convictions;
  • loss or limitation of hospital privileges or disciplinary action;
  • reasons for any inability to perform the essential functions of the position, with or without accommodation;
  • an attestation to the correctness and completeness of the application;
  • a signed and dated Authorization for Release of Information (credentialing warranty).

A complete list of credentialing criteria applicants must adhere to is available for AmeriHealth New Jersey and AmeriHealth Pennsylvania.

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