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Behavioral Health Provider FAQ

How do I credential and contract with AmeriHealth Caritas Louisiana?

If you have not received a network participation package from AmeriHealth Caritas Louisiana, we encourage you to contact us at 1-888-922-0007 or email us at network@amerihealthcaritasla.com to request a contracting packet.

I am already an AmeriHealth Caritas Louisiana provider. What do I need to do to continue seeing AmeriHealth Caritas Louisiana members?

Contact your provider account executive (PDF) to ensure proper setup to provide specialized behavioral health services, if applicable.

What will happen to members that are currently being treated by a behavioral health practice/practitioner that chooses not to participate in the AmeriHealth Caritas Louisiana network?

If you/your practice choose not to join the AmeriHealth Caritas Louisiana network, AmeriHealth Caritas Louisiana will work with you to transition members currently in your care to in-network providers in accordance with applicable continuity of care provisions. If you continue to provide services to AmeriHealth Caritas Louisiana members after a 90-day continuity of care period, all services provided will require prior authorization.

What is the effective date of this transition?

December 1, 2015.

What is the reimbursement?

AmeriHealth Caritas Louisiana will reimburse participating providers consistent with the Medicaid rate in effect on the date of service.

Where can I find the AmeriHealth Caritas Louisiana provider handbook?

You can find the AmeriHealth Caritas Louisiana provider handbook (PDF) online. You should read the provider handbook as well as the AmeriHealth Caritas Louisiana claim filing instructions (PDF). These documents will provide information and guidance on AmeriHealth Caritas Louisiana policies and procedures. The provider handbook will be amended later in 2015 to include policies and procedures specifically applicable to behavioral health services.

When can behavioral health requests for authorization be sent to AmeriHealth Caritas Louisiana?

Authorizations for behavioral health services to be provided on December 1, 2015, or after can be requested from AmeriHealth Caritas Louisiana 60 days prior to go-live on December 1, 2015.

How does my organization credential with AmeriHealth Caritas Louisiana? Do we have to go through a credentialing process?

Your participation in the network is contingent upon the completion of credentialing, so we encourage you to complete the application as soon as possible and return it to your provider network account executive (PDF). AmeriHealth Caritas Louisiana has credentialing criteria for different provider types:

  • For providers who are classified as an individual practitioner or independent practice groups - AmeriHealth Caritas Louisiana uses Council for Affordable Quality Healthcare (CAQH) for credentialing. This is a national, web-based service. Through CAQH, it is quick and easy to complete your credentialing application packet and you can share your application with any other health plans who participate with CAQH. Visit the CAQH website for more information. If you are interested in becoming a provider, please take time to visit our non-participating providers page for additional information. Should you have any questions, please contact AmeriHealth Caritas Louisiana at 1-888-922-0007.
  • For providers, who are classified as an organization or facility - AmeriHealth Caritas Louisiana seeks to simplify the credentialing process by credentialing at the facility or legal entity level. Your organization will be assigned a dedicated AmeriHealth Caritas Louisiana network management account executive to complete the credentialing and contracting process. Please contact Provider Services for assistance with contacting your account executive.

How does this transition affect non-behavioral health services currently rendered under my AmeriHealth Caritas Louisiana provider agreement?

This transition will not affect your provision of non-behavioral health services that you currently render under your AmeriHealth Caritas Louisiana provider agreement.

Which clinical guidelines should I be using for AmeriHealth Caritas Louisiana after December 1, 2015?

AmeriHealth Caritas Louisiana will be using the Interqual Guidelines effective December 1, 2015. AmeriHealth Caritas guidelines will be in effect as well.

Refer to AmeriHealth Caritas Louisiana important contact numbers for more information. You can also download and print this FAQ (PDF).