Effective June 1, 2019, all certified registered nurse
practitioners (CRNP) and physician assistants (PA) will be required to
be credentialed to provide independent, unsupervised services to AmeriHealth
members.
Note: These updated requirements only affect CRNPs and PAs who want
to see an AmeriHealth member on their own without physician supervision. These
new requirements would also not allow a CRNP or PA to see a member for an
initial visit, because that requires a physician.
Becoming a credentialed CRNP or PA
In order to make this new requirement as seamless as possible, AmeriHealth
will accept requests for participation in our network as a CRNP or PA
beginning January 1, 2019, through April 1, 2019. Applications received
after April 1, 2019, may not be processed prior to June 1, 2019. CRNPs
and PAs not credentialed by June 1, 2019, will not be able to
render services to AmeriHealth members. Please allow up to 45 business
days to process applications.
For information on our network credentialing process and credentialing
criteria, please visit the credentialing webpages for AmeriHealth New Jersey or AmeriHealth Pennsylvania. CRNPs and PAs
should apply for credentialing by completing the online Practitioner
Participation Form for AmeriHealth New Jersey or AmeriHealth Pennsylvania.
Any professional provider interested in participating in our network must
complete a Practitioner Participation Form. You can simplify this
process by using the Council for Affordable Quality Healthcare?s (CAQH) online
credentialing application: CAQH
ProView?.
Note: If you have already been credentialed, there is no need to
resubmit a credentialing application.
More information
We will publish more information about this requirement in future
Partners in Health UpdateSM articles.