Provider Manuals, Policies and Forms

Manuals and guides

AmeriHealth Caritas North Carolina 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. Please see Attachment B in the appendix for the Provider Manual Revision Log for a complete list of updates.
  • Behavioral health utilization management guide PDF
    Use this guide to learn more about behavioral health services that require prior authorization.
  • Care Gaps response form provider guide PDF
    The Gaps Response Form functionality allows providers using the NaviNet portal to enter Care Gap resolution data online.
  • Claims and billing manual PDF
    This guide will help you avoid delays in the processing of your claims. Please see the Claims and Billing Guide Revision Log on page 104 for a complete list of updates.
  • Provider member reassignment guide PDF
    Review this guide for tips on how to update NCTracks, add a member to your panel or request to release and reassign someone from your panel.
  • Provider reference guide PDF
    Keep this sheet of contact information close by for when you need to give us a call.

Policies

If you have questions about these materials or about AmeriHealth Caritas North Carolina, contact your Account Executive.

Forms

Advance directives

Early and Periodic Screening, Diagnostic and Treatment (EPSDT)

Grievances and appeals

Long-term services and supports (LTSS)

Maternity

Medical prior authorization

Member Intervention Request

Pharmacy prior authorization

Provider change

Reproductive health

Providers