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Frequently Asked Questions

How do you get more information on your Primary Care Practitioner (PCP)?

You can always call 1-855-809-9200, if you have any questions about your doctor.

How can I choose or change my PCP or other health care provider?

To choose or change your PCP or other Health Care Provider, go to Find a Provider. You can find a list of PCPs and providers that are in the AmeriHealth Caritas Northeast network. Then call Member Services at 1-855-809-9200 to ask for the change.

How do I get a list of all participating providers?

Call 1-855-809-9200, and ask that a list be sent to you.

What services does AmeriHealth Caritas Northeast cover?

Please go to our Benefits page.

What do I do if I get a bill from a health care provider?

As an AmeriHealth Caritas Northeast Member, you are not responsible to pay for medically needed, covered services. You may, however, be responsible for co-payments.

You can be billed for health care services if one of these situations happens to you:

  • A service is provided without prior authorization in cases when prior authorization is required; or
  • A service is provided by a provider who is not in the AmeriHealth Caritas Northeast's network and prior authorization was not given to see the provider; or
  • A service provided is not covered by AmeriHealth Caritas Northeast and your health care provider told you before you received the service.
  • Your health care provider can also bill you for co-pays that were not paid at the time you received the service.
    If you get a bill from a health care provider, you should call the health care provider listed on the bill and make sure they have all your insurance information. If you still feel you were billed in error, you should call AmeriHealth Caritas Northeast Member Services.

Who can I call if I have Special Needs?

If you or your family has a special need that needs attention, please call the Special Needs Unit at 1-888-498-0766. We are here to help you!

How do I know AmeriHealth Caritas Northeast is providing me with quality care?

AmeriHealth Caritas Northeast works to give you the best quality health care. Take a look at our Quality Improvement Program to learn more!

How can I make suggestions about improving my health care services?

Please call 1-855-809-9200 and ask for a representative.