AmeriHealth Caritas Ohio 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 Ohio 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 Ohio 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 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 submit them 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. Prior authorization submission and processing: The prior authorization systems continue to operate normally.
  4. 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 1-833-644-6001.

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.

Latest updates

Electronic claims submission

Providers with Electronic Data Interchange (EDI) capabilities may submit claims, eligibility inquiries, claim status inquiries, and associated attachments using Electronic Data Interchange (EDI) by being a trading partner (TP) authorized by ODM or by contracting with an ODM-authorized TP. For more information, visit

Direct claim entry

Direct Data Entry (DDE) providers should submit claims via the AmeriHealth Caritas NaviNet Provider Portal. Visit our claims and billing page for more information.

Medicaid Annual Eligibility Redetermination Reviews

Important information for providers regarding Annual Eligibility Redetermination Reviews.

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Ohio Department of Medicaid (ODM) billing guidelines

AmeriHealth Caritas Ohio’s Payer ID

  • For all claims EXCEPT transportation: 35374

All claims sent to AmeriHealth Caritas Ohio, through the central PNM portal, should include the AmeriHealth Caritas Ohio Payer ID in 1000B Receiver Loop and 2010BB Payer Name Loop.

AmeriHealth Caritas Ohio Provider Services is available Monday through Friday, 7 a.m. to 8 p.m., except for the following holidays: New Year’s Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Thanksgiving Day, the day after Thanksgiving, and Christmas Day. Phone: 1-833-644-6001. Emergency closures will be listed on our Alerts and Newsletters page.