How To Submit Claims To AmeriHealth Caritas

For AmeriHealth Caritas, the practical claims workflow usually starts with electronic submission guidance and only falls back to paper instructions when the payer documents a mailing address for specific claim types or exceptions. The details below keep the workflow broad instead of reducing it to a single address.

At a glance

• Claims can be submitted electronically through clearinghouses/EDI, with AmeriHealth Caritas Next using Change Healthcare in the cited materials. Electronic payer IDs vary by state/product. The official manual recommends EDI and also describes paper claim filing requirements. Corrected claims should be submitted only after an original claim has processed, and the manual warns that handwritten/stamped 'corrected/resubmitted/voided' language on paper claims will cause rejection. Specific mailing addresses for claims were not conclusively captured from the official sources reviewed, so they are left empty.

Submission channels

• EDI through Change Healthcare or another clearinghouse/vendor
• Change Healthcare ConnectCenter
• NaviNet claim investigation / adjustment inquiry for some adjustments
• Paper CMS-1500 / UB-04 where allowed by plan instructions

Electronic claims payer IDs

• AmeriHealth Caritas Next (Delaware) payer ID 47073; Change Healthcare CPID 9426 (professional) / 7043 (institutional)
• AmeriHealth Caritas Next (Florida) payer ID 45408; Change Healthcare CPID 9427 (professional) / 7044 (institutional)
• AmeriHealth Caritas Next (North Carolina) payer ID 83148; Change Healthcare CPID 9192 (professional) / 6038 (institutional)
• First Choice Next (South Carolina) payer ID 57103; Change Healthcare CPID 9425 (professional) / 7042 (institutional)

Paper claims addresses

• Not clearly published in the researched sources.

Corrected claims and follow-up

• Use a corrected claim only after the original claim has processed and you need to change submitted information.

• Use the same frequency code and include the original claim number.

• If changing member ID or provider tax ID, void the original claim and submit a new one.

• Do not handwrite or stamp 'corrected, resubmitted, or voided' on paper claims.

• Claims status resource 1

Caveats

• Submission details vary by state and product; the payer ID list above is taken from the Next claims manual and should not be generalized to all AmeriHealth Caritas plans.
• The official materials emphasize verifying acceptance/rejection reports; a claim rejected by the EDI vendor is not received by the plan.
• Specific paper mailing addresses were not reliably extractable from the located official sources, so none are provided.

Provider resources

• AmeriHealth Caritas Contact Us (official)
• AmeriHealth Caritas Next Provider Manual (Florida, 2025) (official)
• AmeriHealth Caritas Next Claims and Billing Manual (North Carolina) (official)
• AmeriHealth Caritas Next Prior Authorization Lookup (Florida) (official)
• AmeriHealth Caritas Next Prior Authorization Lookup (North Carolina) (official)
• AmeriHealth Caritas Next Prior Authorization Lookup (Delaware) (official)
• AmeriHealth Caritas Next Prior Authorization / NaviNet (Florida) (official)
• NaviNet provider portal (AmeriHealth Caritas Next Florida) (official)
• Jiva prior authorization portal (AmeriHealth Caritas Next North Carolina) (official)

Sources