Provider Resources

As our provider partners, one of AmeriHealth Caritas Florida's goals is to provide you the resources that you need in a clear, easy-to-find manner. In this section, you'll find items such as member benefit information, credentialing and prior authorization, and how to file a grievance or complaint.

Member information

Hospital resources

  • Resource guide (PDF)
    Department resource guide with information that may be helpful in assisting with coordination and authorization as part of a discharge plan.
  • Prior authorization
    Information and processes regarding prior authorization for member treatment and services.

Other resources

  • Bright Start®
    A maternity case management program providing prenatal and postpartum services.
  • Care gaps
    Find missing recommended services (care gaps) for your AmeriHealth Caritas Florida members right on NaviNet. 
  • Credentialing
    Provider credentialing through the Council for Affordable Quality Healthcare (CAQH).
  • Forms
    All the forms you need in one place.
  • Let Us Know program
    A partnership with the provider community in the management of chronically ill members.
  • NaviNet
    NaviNet is an easy-to-use, no-cost, web-based platform that links providers to AmeriHealth Caritas Florida.
  • Pharmacy services
    Drug formularies, pharmacy prior authorization process, and other pharmacy resources.
  • Prior authorization
    Information and processes regarding prior authorization for member treatment and services.
  • Provider complaints
    How to dispute AmeriHealth Caritas Florida's policies, procedures, or any aspects of AmeriHealth Caritas Florida administrative functions.
  • Provider manual (PDF)
    Explore the latest provider manual, which now fully incorporates the claims manual.
  • Resource guide (PDF)
    Department resource guide with information that may be helpful in assisting with coordination and authorization as part of a discharge plan.
  • Trauma-informed care (TIC) 
    Trauma can have serious effects on people’s health, behaviors, relationships, and other aspects of day-to-day life. Health care providers of all disciplines are encouraged to learn more about trauma-informed care (TIC).

 If you have questions or require more information, call Provider Services at 1-800-617-5727 to speak to a representative.