AmeriHealth Caritas Delaware Providers

Attention Providers

Change Healthcare System Interruption

Change Healthcare, our electronic data interchange (EDI) clearinghouse for claims and payment cycle management, continues to address their network interruption related to a security incident. Below are updates for our systems and processes:

  1. Electronic remittance advice (ERA/835) files: IMPORTANT UPDATE: AmeriHealth Caritas Delaware is pleased to inform you that a solution has been developed in collaboration with Change Healthcare/Optum to provide the detailed payment recovery information missing from the provider remittance advice. This solution will provide payment recovery details on the remittance advice or 835 you receive with your payments for claims processed on and after May 6, 2024. 

    For claims processed February 21, 2024, through May 5, 2024, AmeriHealth Caritas Delaware has generated a comprehensive claims recovery report available in the NaviNet provider portal. For more details for accessing this report see the Remittance Advice Payment Recovery Details Now Available! (PDF) provider notice. 

    Providers can view and download an electronic remittance PDF via the NaviNet provider portal. Providers may also access the ERA/835 file through ECHO Health. For additional information, please see the 835 Access provider notice.

  2. Claims payments: Providers who were unable to successfully submit claims during the outage may now submit them either through Availity or PCH Global, or through Change Healthcare once connectivity is restored. We have extended the claims timely filing deadline for claims that would have been rejected due to untimely filing during the service interruption. For more details, see the Claims Timely Filing Deadline Extension provider notice.
  3. Electronic claims submission through Availity: If you or your clearinghouse do not currently use Availity to submit claims, you must register with Availity at: Please choose the registration option that aligns with your business: Healthcare or Atypical Provider.
    • For registration process assistance and other resources, access the training site link on the Availity registration page.
    • If you are currently registered with Availity for another payer, or if you use another clearinghouse, you must request that they route your electronic claims for to Availity.
    • For additional information and resources, see the recent Additional Information for Availity provider notice.
  4. Submitting claims through Change Healthcare – Although AmeriHealth Caritas Delaware has not reconnected directly to Change Healthcare, providers may submit claims to AmeriHealth Caritas Delaware through Change Healthcare. 
    • Providers may use Relay Health or iEDI (the two clearinghouses being offered today by Change Healthcare/Optum) for submitting claims to AmeriHealth Caritas Delaware. Claims submitted through these clearinghouses will be routed to us via Availity until we reestablish direct connectivity to Change Healthcare.
      • To use Relay Health or iEDI, you will have to establish new connectivity with these clearinghouses.
      • For new connectivity requirements, you will need to reach out to your Change Healthcare account representative.
  5. Manual claims submission through PCH Global: To enroll for claims submission through PCH Global, please go to and click the Sign-Up link in the upper right-hand corner to register.  
    Complete the registration process and log into your account. You will be asked how you heard about PCH Global; select Payer, then AmeriHealth. Access your profile by clicking on Manage User and then My Profile. You will need to complete all the profile information. When you go to the Subscription Details screen, select the More option on the right-hand side to see how to enter the promo code Exela-EDI.
    When you are ready to submit claims, use the following information to search for our payer information:
    a. Payer name: AmeriHealth Caritas Delaware
    b.  P.O. Box: 801100
    For a detailed walk through of the registration process, refer to the PCH Global Registration manual, found on the PCH Global website in the Resource Menu.
  6. Prior authorization submission and processing: The prior authorization systems continue to operate normally.
  7. Eligibility verification, claim status inquiry, and authorization inquiry: These capabilities continue to be available via NaviNet. If you do not have access to NaviNet provider portal, please visit to sign up.
    Please note, in the interim, our Provider Services Department will not be able to assist with processing of your payments or obtaining your 835 files any sooner. If you have other questions, you may contact Provider Services at 1-800-999-3371

We thank you for your partnership and patience, We will continue to provide updates as we work to resolve the downstream impacts of Change Healthcare’s service interruption.

Thank you for choosing AmeriHealth Caritas Delaware

We are AmeriHealth Caritas Delaware, a mission-driven Medicaid managed care organization. Through dedicated providers like you, we serve Delaware Medicaid members in the Diamond State Health Plan (DSHP), Delaware Healthy Children Program, DSHP-Plus, and DSHP-Plus LTSS programs.

With your partnership, we aim to deliver excellent care and improved health outcomes to our members.

If you have questions, you can call AmeriHealth Caritas Delaware Provider Services at 1-855-707-5818.


Have you registered your NPI, Taxonomy and Location with DMAP? If not, you will not be eligible for Medicaid payments after September 30, 2024.

In compliance with 42 CFR § 438.602 [] and 42 CFR Part 455 [], subparts B and E and the 21st Century Cures Act [], Delaware Medicaid is required to screen and enroll all current and prospective Managed Care Organization-Only Providers (MCOPs).

For additional Information, please contact DMMA:

Provider Services at 1-800-999-3371; Option 0, then Option 4

Email* - *Reminder: Do not send any correspondence that has protected health information (PHI) to this mailbox.

Submit a 275 claim attachment transaction

AmeriHealth Caritas Delaware is accepting ANSI 5010 ASC X12 275 unsolicited attachments via Change Healthcare. Please contact your Practice Management System Vendor or EDI clearinghouse to inform them that you wish to initiate electronic 275 attachment submissions via payer ID: 77799

There are three ways that 275 attachments can be submitted.

  • Batch — You may either connect to Change Healthcare directly or submit via your EDI clearinghouse.
  • API via JSON — You may submit an attachment for a single claim.
  • Portal — Individual providers can register at Change Healthcare to submit attachments.

The acceptable supported formats are PDF, tif, tiff, jpeg, jpg, png, docx, rtf, xml, doc, and txt.  View the Change Health Care 275 claims attachment transaction video for detailed instructions on this new process.

In addition, the following 275 claims attachment report codes have been added effective 8/1/23.  When submitting an attachment, use the applicable code in field number 19 of the CMS 1500 or field number 80 of the UB04, as documented in the Claims Filing Instructions (PDF).

Attachment type Claim assignment attachment report code
Itemized bill


Medical records for HAC review


Single Case Agreement (SCA)/LOA 04
Advance Beneficiary Notice (ABN) 05
Consent Form CK
Manufacturer suggested retail price/innovation 06
Electric Breast Pump Request Form 07
CME Checklist consent forms (Child Medical Eval) 08
EOBs – for 275 attachments should only be used for non-covered or exhausted benefit letter EB
Certification of the Decision to Terminate Pregnancy CT
Ambulance trip notes/run sheet AM

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