AmeriHealth Caritas Ohio Providers
Your recommendation matters and is one of the stronger factors in a member’s decision to get vaccinated.
Please take a moment to discuss the benefits of flu and RSV vaccines during this flu season.
Latest updates
Electronic claims submission
Providers with Electronic Data Interchange (EDI) capabilities may submit claims, eligibility inquiries, claim status inquiries, and associated attachments using Electronic Data Interchange (EDI) by being a trading partner (TP) authorized by ODM or by contracting with an ODM-authorized TP. For more information, visit ODM's trading partners webpage.
Direct claim entry
Direct Data Entry (DDE) providers should submit claims via the AmeriHealth Caritas Ohio NaviNet Provider Portal. Visit our claims and billing page for more information.
Medicaid annual eligibility redetermination reviews
Important information for providers regarding annual eligibility redetermination reviews.
Ohio Department of Medicaid (ODM) billing guidelines
- Ohio Department of Medicaid billing information
- ODM HIPAA Transaction Standard Companion Guide: 837 Institutional Fee-For-Service Claims (PDF)
- ODM HIPAA Transaction Standard Companion Guide: 837 Professional Health Care Claim (PDF)
- ODM HIPAA Transaction Standard Companion Guide: 837 Dental Fee-For-Service Claims (PDF)
AmeriHealth Caritas Ohio’s Payer ID
- For all claims except transportation: 35374
All claims sent to AmeriHealth Caritas Ohio through the central PNM portal should include the AmeriHealth Caritas Ohio Payer ID in 1000B Receiver Loop and 2010BB Payer Name Loop.
AmeriHealth Caritas Ohio Provider Services is available Monday through Friday, 7 a.m. to 8 p.m., except for the following holidays: New Year’s Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Thanksgiving Day, the day after Thanksgiving, and Christmas Day. Phone: 1-833-644-6001. Emergency closures will be listed on our alerts and newsletters page.
If you need more information or can’t find an answer to your question, check your provider manual (PDF). You can also call AmeriHealth Caritas Ohio Provider Services at 1-833-644-6001.