Provider Manuals, Policies, and Forms
Manuals and guides
AmeriHealth Caritas Ohio offers these reference materials to our providers for use when treating our members.
- Provider manual (PDF)
This manual will help you and your office staff provide services to our members.
If you have any questions, call Provider Services at 1-833-644-6001, or contact your Provider Services Account Executive.
Forms
Ohio Department of Medicaid forms
- Abortion Certification (PDF)
- Acknowledgment of Hysterectomy Information (PDF)
- Aceptación de la Información Sobre Histerectomia (PDF)
- Consent for Sterilization (PDF)
- Consentimiento Para La Esterilización (PDF)
- Healthchek and Pregnancy Related Services Information Sheet (PDF)
- Medicaid Advisory Letter and Attestation (PDF)
- Pregnancy Risk Assessment Communication (PRAF) (PDF)
Submit this form to assist pregnant women in maintaining Medicaid eligibility and to connect them toneeded services and supports, such as home visits. - Prior Authorization Request Form (PDF)
- Report of Pregnancy (ROP) (PDF)