Let Us Know Program

AmeriHealth Caritas Next is here to help you engage members in their health and well-being. Let us know when you or our members need our help.

When members need assistance managing their health, we can help!

Clinical resources

Use our Member Intervention Request Form (PDF) to let our Rapid Response and Outreach Team know of members whom we can assist with issues, such as:

  • Missing an appointment
  • Behavioral health assistance
  • Medication noncompliance
  • Care management engagement
  • Developmental screening issues
  • Emergency room misutilization
  • Limited to no knowledge of plan benefits
  • Needs related to social determinants of health
  • Tobacco cessation referral

For questions, call the Rapid Response and Outreach Team at 1-833-435-7708.

Look up member care gaps

You can view member care gap information using our NaviNet provider portal to determine when a member is overdue for preventive care services or may be underutilizing disease-specific medication. There are two ways to view member care gap information and access a Care Gap Worksheet in NaviNet:

  1. Report Inquiry — You may view a Care Gap Worksheet for a specific member by using the Report Inquiry option from the transaction menu.
  2. Pop-up alert — If a member has a care gap, an alert message will appear on your screen when checking their eligibility and benefits. You can click on the alert to access a Care Gap Worksheet for that member.

You can use the Care Gap Worksheet to request that our Rapid Response and Outreach Team contact the member.

Log in to NaviNet to view member care gaps. Not registered? Sign up now. Learn more about all the services our provider portal offers by viewing our NaviNet resources webpage.

Refer to Care Management

AmeriHealth Caritas Next offers care management programs to assist members with their specific health needs. Learn about these programs on our website or use our Member Intervention Request Form (PDF) to refer a member to a program. You may also call the Rapid Response and Outreach Team at 1-833-435-7708 for additional assistance.

Bright Start® pregnancy program

Bright Start helps pregnant members have healthy pregnancies and prepare for the arrival of their babies. Learn about Bright Start on our website or use our Member Intervention Request Form (PDF) to refer a member to the program. You may also call the Bright Start Team at 1-833-643-2262 for additional assistance.

Other Provider Services

  • Provider Services: 1-855-266-0219
  • Provider Services fax: 1-833-559-2262
  • Utilization Management: 1-833-702-2262
  • Utilization Management fax: Physical Health: 1-844-412-7890 Behavioral Health: 1-855-243-6352
  • Credentialing: 1-855-266-0219
  • Provider Account Executives Contact Information (PDF)

Enrollment verification

To verify that a patient is an AmeriHealth Caritas Next member, log in to NaviNet, our provider portal. Not registered for NaviNet? Sign up now.

For Providers