Credentialing
Become a participating provider
AmeriHealth Caritas Louisiana offers practitioners the Universal Provider Datasource (UPD) through an agreement with the Council for Affordable Healthcare (CAQH). There is no charge to providers to participate in CAQH or to submit an application.
To submit your application with AmeriHealth Caritas Louisiana via CAQH:
- Register for CAQH at www.caqh.org.
- Grant authorization for AmeriHealth Caritas Louisiana to view your information in the CAQH database.
- Send your CAQH ID number to AmeriHealth Caritas Louisiana at providerenrollment@amerihealthcaritasla.com or by fax to 1-225-300-9199.
ACT 143
In accordance with La. R.S. 46:460.61, as amended by Act 143 of the 2022 Regular Session, the following providers shall be considered to have satisfied, and shall otherwise be exempt from having to satisfy, any credentialing requirements of a managed care organization:
- Any provider who maintains hospital privileges or is a member of a hospital medical staff with a hospital licensed in accordance with the Hospital Licensing Law, La. R.S. 40:2100 et seq.
- Any provider who is a member of the medical staff of a rural health clinic (RHC) licensed in accordance with La. R.S. 40:2197 et seq.
- Any provider who is a member of the medical staff of a federally qualified health center (FQHC) as defined in La. R.S. 40:1185.3.
The following table indicates how the providers described above may notify AmeriHealth Caritas Louisiana of their status when they initially join a hospital, RHC, or FQHC, or prior to the expiration of their current credentialing.
|
Hospital Providers |
Providers who maintain hospital privileges or are a member of a hospital medical staff |
|
|---|---|---|
|
FQHC or RHC Providers |
Providers who are a member of an FQHC or RHC |
|
Credentialing and recredentialing requirements
The following types of practitioners require initial credentialing and recredentialing every 36 months:
- Audiologists
- Certified nurse midwife
- Chiropractors
- CRNPs
- Language pathologists*
- Occupational therapists*
- Oral surgeons
- Physicians (DOs and MDs)
- Podiatrists
- Physical therapists
- Speech therapists
- Therapeutic optometrists*
*Only private practice occupational, physical, and speech therapists require credentialing.
Additional credentialing information
- Application checklist for facilities (PDF)
- Pathologist, Anesthesiologist, Radiologist, Emergency Medicine, Neonatologist, and Hospitalist (PAREN) data entry (PDF)
- Practitioner and facility credentialing rights
- Practitioner credentialing and recredentialing application packet (PDF)
- Provider enrollment form (PDF)
- Facility credentialing and recredentialing application packet (PDF)