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.
Hospital resources
- Covered services: Expanded benefits guide (PDF)
A guide detailing all expanded benefits available to AmeriHealth Caritas Florida Medicaid members.
- 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
- Behavioral health and substance use
Education and support for our network providers.
- 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.
- Clinical resources
Clinical practice guidelines and related information for providers.
- COMPASS program guide (PDF)
AmeriHealth Caritas Florida COMPASS program guide.
- Continuity of Care (COC)
Detailing continuity of care for AmeriHealth Caritas Florida members.
- Covered services: Expanded benefits guide (PDF)
A guide detailing all expanded benefits available to AmeriHealth Caritas Florida Medicaid members.
- Credentialing
Provider credentialing through the Council for Affordable Quality Healthcare (CAQH).
- Cultural competency
Understand how to meet the cultural and linguistic needs of our members.
- Durable Medical Equipment (DME)
DME benefit and covered services.
- EHR incentives/meaningful use
Electronic health records (EHR) overview for providers and healthcare professionals on the HealthIT.gov website.
- EPSDT/Child Health Check-Up Visits
Early and Periodic Screening, Diagnostic and Treatment.
- Forms
All the forms you need in one place.
- Healthy Behaviors programs
Information about programs that reward members for implementing healthy behaviors.
- Important phone numbers
Important phone numbers.
- 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.
- Opioid overdose prevention
Opioid information from the Centers for Disease Control and Prevention (CDC).
- 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.
- Reducing Disparities in the Management of Hypertension in African American Patients
A toolkit for providers that shares best practices, strategies, no-cost trainings, and support available, for working to reduce high blood pressure in your African American patient population.
- Reimbursement Policies
Reimbursement policies and related information for providers.
- Resource guide (PDF)
Department resource guide with information that may be helpful in assisting with coordination and authorization as part of a discharge plan.
- Subcontractor/vendor training (PDF)
Guidelines for vendors to ensure compliance.
- Telehealth (PDF)
Telehealth attestation form.
- 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.