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.

Quality Enhancement Program (QEP)

We are committed to helping you deliver the best care to your patients. In an effort to meet our providers' needs and priorities for care delivery, we created the Quality Enhancement Value-Based Compensation Program for participating providers.

The program features a unique reimbursement model intended to reward providers for delivering high-quality and cost-effective care. Providers are rewarded for each member who is attributed to the practice and receives the recommended wellness or preventive care outlined in each of the quality metrics.

Policies

If you have any questions about these materials or about AmeriHealth Caritas North Carolina, call Provider Recruitment at 1-844-399-0474, or contact your Account Executive.

Forms

Advance directives

Early and Periodic Screening, Diagnostic and Treatment (EPSDT)

Grievances and Appeals

Let Us Know (Rapid Response and Outreach Team)

Long-Term Services and Supports (LTSS)

Maternity

Medical Prior Authorization

Pharmacy Prior Authorization

Provider Change